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To prevent misconception, it may be well to say 
that this work does not profess to be a guide-book 
to spas, although it is intended to supply information 
which will afford aid in the selection of such of them 
as are suited for particular cases. 

To save the reader the trouble of constant reference 
to larger maps, an outline one has been prepared, on 
a small scale, which may serve to point out the general 
position of places. 

Curzon Street, Mayfair, 
April 23, 1869. 



Half-knowledge— Mystery — Fondness for marvellous Cures — Abuse 
no Argument against Use of Waters — Their Action becoming 
better understood — Many old Theories dropped—Object of this 
Book — English run too much to particular Spas — Sources of 
Information Pages $ — II 




Agencies complex— Opinion of Trousseau— Of Beale — Travelling — 
Diet at Spas — Special Rules — Routine of drinking and bathing — 
Heavy table d^hdte Dinners — Amusements — Gambling — Rules 
for selection of Spas — The crowded ones— Faith in their 
virtues not to be disturbed — A Statement of Case desirable- 
Directions of the Bath Doctor to be followed— Waters not 
innocuous — Preparatory Treatment — Length of Cure — After 
Cures — What can be fairly attributed to the Cure — Cases are 
of chronic nature —Objection that Effects are not lasting. . 

Pages 12 — 27 




Effects of change of Air not always explicable — Best Season of the 
Year — But many Baths may be visited at any Season — Mountain 
Air ; its characteristics— Climates modified by local influences — 
Effects of Air at high elevations magnified — Theory of operation 
of Mountain Air — Practical View of it — Alpine Zones — Diseases 
of Hill Countries — Of the Respiratory Organs in the Hima- 
layas — In Switzerland — Therapeutic action of Mountain Air — 
For what form of Consumption fitted — For what other diseases — 
Contra-indications — Sea Air ; its general qualities ; its operation 
theoretically — Places of resort ; what is most wanted in them — 
Sea-side better than inland places for Chest Affections — Advan- 
tages of Sea-voyages — Comparison of effect of Mountain and of 
Sea Air— Our own Mountain Air — Hot-air Baths — At present 
fashionable — Compressed Air — Theory of its effects — Retardation 
of Respiration — Cases in which used .... Pages 28 — 50 



Does Skin absorb Water? — Cold Baths ; their operation — Hydro- 
therapy — Warm Baths ; their action — Vapour Baths — Influence 
of Hot and Cold Baths on secretion — Comparison of the effects 
of Hot and of Cold Baths — Indications for the Water Cure — 
Contra-indications — Mode of using Baths — Douches — Drop and 
Shower Baths — Dry rubbing — Sudation — Function of the Skin 
—Perspiration — Excretion of Morbid Matter — Injurious effects 
of Hot and Cold Baths when used unwisely . . Pages 51 — 73 



Importance of Water in the economy — Rate and mode of its 
absorption — Its influence on the System, and on the Secretions — 


Effects of too much and of too little Water — Therapeutic action 
of Water drinking — Different effects of Hot and of Cold Water — 
Bath Fever and Eruptions — Bad effects of the excessive use of 
Water Pages 74—85 



What are Mineral Waters? — What are their Constituents? — The 
important ones — Baregine — What attracted attention first? — 
Heat, Smell, Colour, Taste — Where they are most common — 
Geological Formations — Principles of Classification — French 
and German Tables — Mixed Classification used here — Property 
of State or of Individuals — General arrangements for bathing 
and drinking — Government Baths — Mineral Waters in India — 
Best modern buildings — Varieties of Baths . . Pages 86 — 100 




Effects of Baths of these classes chiefly the same as of Hot Baths — 
Trifling amount of absorption — Constituents of Indifferent and 
of Earthy Baths — Elevated situation of many of them — Their 
therapeutic effects in Neuralgia, Paralysis, Gout, Rheumatism, 
Enlarged Joints — Gastein, Romerbad, Pfeffers, Wildbad, 
Leibenzell, Teinach, Badenweiler, Schlangenbad, Bertrich, 
Teplitz, Plombieres, Neris, Oviedo, Panticosa, Buxton — Earthy 
Waters : Lucca, Bormio, Leuk, St. Didier, St. Amand, Bagneres 
de Bigorres, Sacedon, Bath, Clifton, Mallow . Pages 101 — 126 




Operation of Sulphur Baths — Their Use in Skin Complaints — The 
dartrous condition — Syphilis — Metallic poisoning — Uterine com- 
plaints — Inhalation — Bareges, Cauterets, St. Sauveur, Eaux 
Chaudes, Bagn^res de Luchon, Amelie les Bains, Le Vernet, 
Ax, Escaldas, Aix les Bains, Marlioz, Pietrapolo, Guagno, 
Guitera, Puzzichello, Baden in Switzerland, Schinznach, Baden 
in Austria, Aix-la-Chapelle, Acqui, Abano, Battaglia — Some 
Spanish Sulphur Waters Pages 127 — 143 



Their Operation depends on their strength — General Effects — Their 
use in Scrofula, in Complaints of Women, in Rheumatism, and 
in Gout — Weak Salt Waters : Wiesbaden, Baden Baden, Bour- 
bonne les Bains, Bourbon l'Archambault, Balaruc, Caldas de 
Montbuy, Trillo, Canstatt, Soden, Cronthal — Carbonic Acid 
Salt Baths — Their Operation — Use in low states of system — In 
Chronic Nervous Affections — Nauheim, Rehme, Kissingen — 
Stronger, or Sool-Bader : Ischl, Aussee, Reichenhall, Kreuth, Bex, 
Pyrmont, Diirkheim, Rheinfeld, Kreutznach — Sea-bathing — Com- 
position and Temperature of Sea- Water — General directions 
about Sea-bathing — Useful in Diseases of Women and Children, 
in over-sensibility of Skin, in Scrofula at Berck-sur-Mer, at 
Margate — Contra-indications — German, French, Spanish, Italian, 
English, Scotch, Irish Sea-bathing places — Alkaline, Saline, and 
Steel Baths — Their operation Pages 144 — 167 



Baths — Arenation, Scum, Peat — Use of Peat Baths — Theory of 
their Operation — Their Chemical Composition — Peat Water — 


Pine Balsam — Dregs of Wine — Whey — Gas Baths — Natural ones 
— Carbonic Acid, Hydrosulphuric Acid, Sulphurous Acid, 
Chlorine, Electrical — Vapours of Common Salt, of Chlorine, of 
Sulphur, of Hydrosulphuric Acid, Carbonic Acid, Oxygen, 
Nitrogen, Carburetted Hydrogen — Pine Balsam Pages 168—184 




Immense quantities of Water sometimes drunk — Indifferent Warm 
Waters : Panticosa, Eaux Bonties, Plombieres — Indifferent Cold 
Waters — Earthy Saline Waters — Their Action— Lime their 
largest constituent — Its Use in Rickets, in Scrofula, Tubercu- 
losis, Bladder Affections — Amount of Lime in some Waters used 
both for bathing and drinking — Lippspringe, Wildungen, Fiired, 
Weissenburg, Courmayeur, Chianciano, Contrexeville, Pougues, 
Alzola, Fitero, Cransac — Aluni and Manganese Pages 185 — 197 



Difficulty of determining their Effects— Action of Sulphur and ot 
Sulphurets — Their practical Operation in Hemorrhoidal con- 
ditions, Congested Liver, Metallic Poisoning, early Tuberculosis 
— Weilbach, Nenndorf, Eilsen, Langenbriicken, Meimberg, Aix- 
la-Chapelle, Burtscheid, Stachelberg, Lenk, Gurnigel, Heustrich, 
Le Prese, Alveneu, The Moffettas, La Preste, Visos, Allevard, 
Enghien, Caratraca, Ormeztaguy, Santa Agueda,Gilsland, Moffatt, 
Strathpeffer, Swanlinbar, Lisduvarna — Table of Amounts of 
Sulphuretted Hydrogen Pages 198 — 211 




Common Salt — Action on System — Therapeutic Use — Scrofula, 
Anaemia, Tropical Cachexy, Dyspepsia, Liver, Female Complaints, 
Chronic Affections of Eye and of Ears — Table showing amount of 
Salt— Sea Water — Kissingen, Homburg, Kreutznach, Nauheim, 
Wiesbaden, Baden Baden, Bourbonne and Balaruc, Pyrmont, 
Soden, Cronthal, Canstatt, Ischia, CasteJJamare, Pozzuoli, La 
Porretta, Monte Catini, Cestona, Harrogate, Bridge of Allan, 
Bridge of Earn, Innerleithen Pages 212 — 223 



Alkalies— Action on System — Their Employment in Dyspepsia, 
Liver, Diabetes, Lithiasis, Gout, Mucous Membranes, Respiratory 
Organs, Diseases of Women — Table of Alkaline Waters : Vichy, 
Vals, Vic sur Cere, Chaudes Aigues, Mont Dore, Royat, St. 
Nectaire, Soultzmatt, Heilbrunnen, Ems, Neuenahr, Fachingen, 
Gleichenberg, Fideris, Luhatschowitz , . . . Pages 234 — 248 



Purgative Waters — Chief Constituents : Sulphate of Soda and Mag 
nesia — Their Operation — Their Employment in Obstructions of 
the Portal System, in Haemorrhoids, in Liver, in Spleen, in 
Gout, Lithiasis, Diabetes — Table of Purging Waters — Plain 
Purging Ones : Pullna, Friederichshall, Epsom — Mixed Ones with 
a good deal of Salt : St. Gervais, Uriage, Cheltenham, Learning- 


ton, Scarborough — Mixed Ones with Carbonate of Soda : Carls- 
bad, Giesshiibel, Marienbad, Franzensbad, Elster, Bourboule, 
Rohitsch, Tarasp Pages 249—265 



Iron long a popular Medicine — Required by the System — Its 
physiological Operation — Medical Uses — Local Action — Constitu- 
tional — Malarious Cachexy, Chlorosis, Neuralgias, Hyperesthesias 
— Occurs mainly in Carbonates — Table of Chalybeate Waters : 
Spa, Pyrmont, Alexisbad, Driberg, Liebenstein, Briickenau, 
Bocklet, Schwalbach, Rippoldsau, Petersthal, St. Moritz, St. 
Bernardhine, Wyh, Recoaro, Santa Agueda, Bagneres de Bigorres, 
Orezza, Forges, Bussang, Tunbridge Wells, Harrogate, Tonnis- 
tein, Mitterbad, Ratzes, Auteuil, Passy, Sandrock, Vicars Bridge, 
Hartfell Pages 266—286 



Small amounts of Iodine and of Bromine in various Wells, as Kreutz- 
nach, Wildegg, Krankenheil, Woodhall Spa — Amount too small 
for any real action — Arsenic, Lithium, Boracic Acid, Manganese, 
Silicic Acid — Carbonic Acid — Effects when taken into the Stomach 
— Carbonated Waters useful as Antacids — Divided into those in 
which Soda, and those in which Lime and Magnesia predominate 
— Artificial Waters — Never perfect copies— No guarantee that they 
are what they profess to be — Strongest Waters are most easily 
imitated, also keep best when bottled — Not so useful as when 
drunk at the Spring — Great Exportation — American Waters. 

Pages 287 — 297 





Quackish Advertisements in Germany and in France — Dry Method 
— Extract of Malt — Fresh juices of plants — Bitters — Sap of Birch 
— Of Pine — Grapes — Their Analysis — Comparison of juice with 
the Waters of Vichy — Physiological Action — Use in Abdominal 
Congestions, in Mucous Catarrhs, in Chronic Diarrhoea, in early 
Tuberculosis— Quantity ate — Mode of eating — Contra-indications 
— Grape Cure Stations — Other Fruits — Wild Strawberries — Their 
Analysis — Uses — Refreshing but not nutritious. Pages 298 — 310 



Milk, a specimen of Nature's Food — Varies in Composition 
— Cows', Asses', Goat, Ewe, Mares*, Buffalo—Analysis — Skimmed 
Milk — Butter-milk — Whey — Analysis of it — General Operation 
on the System of Milk and Whey — Milk — Many Uses ; in Irritable 
Stomachs — Dr. KarelTs Treatment with small quantities — Often 
useful when nothing can be done by Medicine — But its great use 
is in larger doses combined with Country Air, in Anaemia, Scrofula, 
Tuberculosis — Niemeyer's Opinion — In Catarrh of Stomach, 
in Chronic Diarrhoea, and Dysentery — Method of Milk Cure — 
Whey — Old Remedy — Much fancy about different kinds — Theory 
of its use in the System — Recommended in Phthisis, in Abdominal 
Affections — Milk, and still more Whey, supply insufficient nourish- 


ment alone — Various Whey Cure Stations — Routine of Treatment 
— Season — Duration of Cure — Butter-milk — Cream — Sour Milk 
— Koumis introduced at some Stations . . . Pages 311 — 327 



I. Of Diseases noticed 331 

II. Of Places named 333 

"Every nation has particular opinions respecting the use of 
baths, and several rules and methods in using them. Drinking 
them is not at all received in Germany ; for all diseases they bathe 
only, and will lie dabbling in the water almost from sun to sun. 
In Italy, where they drink nine days, they bathe at least thirty, 
and commonly drink the water mixed with some other drugs to 
make it work the better. We are here ordered to walk to digest 
it ; there they are kept in bed after taking it till it be wrought off, 
their stomachs and feet having continually hot. cloths applied to 
them all the while ; and as the Germans have a particular practice 
generally to use cupping and scarifications in the bath, so the 
Italians have their doccie, which are certain little streams of this hot 
water brought through pipes, with which they bathe an hour in 
the morning and as much in the afternoon for a month together, 
either the head, stomach, or any other part where the malady lies. 
There are infinite varieties of customs in every country." — Mon- 
taignis Essays, about 1580. 





There are few people, certainly very few women, who 
are not more or less doctors. It is not merely that they 
have some general notions as to what should be done 
in case of sickness, but that they have distinct medical 
opinions and theories of their own. Half knowledge 
and a certain degree of mystery are always captivating 
to the human mind. It is delightful to take a galvanic 
bath, and have the mercury and other poisons which 
have ruined your system, exhibited to you as they are 
mechanically eliminated by electric action — nay, some 
years ago a certain nobleman gave it in evidence, and 
apparently rather to his own satisfaction, that a sub- 
stance resembling lead had been extracted from his 
head by metallic tractors. So, a lady who would not 
dream of wearing an amulet will use a galvanic ring, 
or a patient is assured by an hydropathist that the 
odour of the aloes he has been using for years is 

B 2 


plainly perceptible in his perspiration. What can be 
simpler than the theory of such cases ? Or take another 
instance : a mother is induced to give her child, who 
is suffering from a paroxysm of fever, a few drops at 
night of a medicine which she is told is endued with 
marvellous powers. She watches the operation of the 
drops, the fever gets less towards morning, and she is 
a firm convert to globulism. What can be clearer than 
that the drops cured the fever? that they were not 
ordinary drops of ordinary practitioners ? She has given 
a practical trial to the system, and doubtless, under 
the instructions of friends, had previously mastered its 
plausible theory as completely as most of its professors. 
A scrap of theory, for instance the announcement that 
it is a purifier of the blood, wonderfully helps the sale 
of a quack medicine. Whoever uses such a medicine 
fancies that he understands exactly how he is cured 
by it. A patient in the play does not comprehend 
what the doctor is saying about his case, until he gives 
this explanation : " Je veux dire qu'il y a quantity 
d'humeurs corrompues dans votre corps ;" on which 
the patient at once replies, " Ah ! je vous entends." 

Mystery, or faith, is the next influence in subjection 
to which the patient places himself. A hundred years 
ago, a writer on mineral waters observed : " The public 
is ever captivated with novelty, and ever reveres things 
seeming secret and mysterious." It is wonderful to 
what an extent our faith is drawn on by globulism, 



and other marvel cures, and it is therefore not very 
surprising that those who adopt them are often those 
who evince an extreme readiness of belief on other 
subjects; but it is strange that a practice like that of 
globulism should have arisen amidst the scepticism of 
Germany, and that many who are most critical in 
matters of religion and of philosophy accept readily, 
after little or no examination, the latest novelties in 
the way of wonderful remedies; partly because they 
have never thought much on the subject, partly, no 
doubt, from their fondness for deviating from every- 
thing that is old and established. Curious that the 
extremes of belief and of unbelief should meet in the 
ready acceptance of marvels ! A French savant cures 
an ague by placing a piece of camphor on the pit 
of the stomach, or an Indian medicine-man, clothed 
in mystery garb, dances round the patient until he has 
driven away the fever. In either case faith is the secret 
of the occasional success of the remedy. And while 
man's mental constitution remains what it is, and while 
the problems of medical practice continue to be so 
complex as they are, a certain amount of this implicit 
faith will always be required in regular as well as 
irregular medicine. Although we have not in these 
days got professed witches, unless we accept mesmeric 
mediums as their representatives, there is no question 
that the remark of our greatest philosopher is prac- 
tically true to this day. " In all times, in the opinion 


of the multitude, witches and old women and impostors 
have had. a competition with physicians." To a great 
many minds, faith in some one else is absolutely neces- 
sary ; and many patients are much happier when they 
have erected their doctor into a medical high priest, 
and they look to him for marvellous cures. Viewing 
the relation of a large class of patients to their physi- 
cians in this light ; knowing that the great mass of those, 
especially of English, who resort to baths are not 
seriously ill, at least that their ailments are not acute 
ones, in which imagination can play a comparatively 
small part; and knowing the craving of the public for 
novelty and for wonders, it is not surprising, however 
much it may be subject for regret, that in many instances 
the bath doctors over-praise their waters, proclaim each 
to be a panacea, and even invent novelties in treatment 
in order to keep up the interest of their patients. 

Owing to their disapprobation of such practices, and 
their natural unwillingness to allow that certain effects 
may be produced more easily abroad than at home 
(for we have but few wells of much importance), it is 
not surprising that in England there has been a ten- 
dency among many well-informed medical men to 
underrate the value of mineral waters. But we are 
not to give up a system on account of the unworthy 
acts of some of its professors. In fact it would be 
impossible to put a stop to the resort to bathing 
places. In German families of any means at all it is 


the holiday of the year, which must be kept And 
English find it not more expensive to visit a foreign 
spa, than to go to the seaside at home. Since there 
is something so pleasing in the annual change from 
home; since most of the waters drunk or bathed in 
are either pleasant, or after a time not disagreeable 
(always used more willingly than physic); and since 
the imagination is pleased to dwell upon their hidden 
virtues, visits to spas will always continue to be popular. 
In short, those who condemn mineral waters unfairly, 
would do better if they would study their use, and 
endeavour to explain the rationale of their operation. 
If it were possible, it would not be desirable to destroy 
faith in mineral waters; they produce real enough cures, 
but the faith should be rendered intelligent. To arrive, 
however, at a correct appreciation of all the elements 
concerned in the influence of mineral waters, is by no 
means a simple matter. Still, progress is being made in 
the solution of these questions. The Germans, although 
they can scarcely write a treatise on mineral waters 
without beginning ab ovo, and explaining the influence 
of Baco of Verulam (they will call him Baco) on the 
progress of natural science, have got rid of many old 
notions. It is no longer a matter of anxious inquiry, 
as it was some years ago, whether the patient had 
ever suffered from itch, whether the source of the 
malady was suppressed foot-sweat ; and then abdominal 
plethora or haemorrhoidal dyscrasy are less insisted on. 


The French, though they still have faith in the mystical 
powers of waters, which they have termed animated 
medicines, and believe in a sort of diathesis, which 
they call the " dartrous," are getting emancipated ; the 
ordinary bath theory of fever crises and eruptions 
being essential to cures has been abandoned (not that 
such effects do not occur, not from the use of waters, 
but from their abuse). Then we hear less of the che- 
mistry of nature, and of its being necessarily perfect 

The theory of the operation of waters in bathing 
is better understood. The elementary actions of hot 
and of cold water have been better studied ; purely 
chemical theories, such as that of alkalization of the 
system by certain waters containing soda, or of curing 
scrofula or gout by waters that contain minute quan- 
tities of iodine or of lithia, are no longer counted 
sufficient. The notion that the heat of natural hot 
waters differs from any other heat is abandoned ; even 
later theories of the operation of such waters, by heat 
being placed in certain peculiar dynamic states and 
generating galvanic actions, are seen to be chimerical, 
at all events to afford no satisfactory explanation, as 
our commonest acts involve electrical changes. 

In short, in this as in other departments of medicine, 
we are less inclined to take things for granted, especially 
certain therapeutic actions, and the necessity for an 
analysis of the causation of the facts that come before 
us is admitted by all. But many years of accurate 


observation will be required before satisfactory results 
are attained. These pages pretend to exhibit nothing 
more than a slight sketch of the present condition^ 
our knowledge on the subject, gathered partly from 
personal observation, and necessarily much more from 
every other available source of information. It is hoped 
that they will supply in a condensed shape an outline 
of all that is essential to be known on the subject of % 
which they treat. They are meant to furnish a sort 
of information which may be useful in England at the 
present moment. 

Although few baths that are much out of the track 
of the English on the Continent are noticed here, and 
therefore many in Silesia, Hungary, Wallachia, and 
elsewhere are omitted, yet the number mentioned in 
this book, it is feared, is quite large enough to be 
somewhat embarrassing to some. While the stream 
of English to continental baths is increasing every 
year, and such wells as we have and our excellent 
sea-bathing places are not made as much use of as 
they should be, it seems a pity that the current should 
run so much in one direction, and that it is not turned 
into more channels. Undoubtedly, taken as a whole, 
the German baths are best managed and best suited 
to the taste of English visitors. But many of the 
French ones leave nothing to be desired ; and if 
patients once begin to flock to a new place, it is 
wonderful how soon its arrangements are improved. 


Pretty full notice has accordingly been taken of some 
of the Italian and of the Spanish baths, particularly 
such of the latter as are not far distant from the 
English colony of Pau and the fashionable watering- 
place of Biarritz. While many of the Spanish baths 
are rising into importance, it is much to be regretted 
that the analyses and the accounts generally of these 
waters are very imperfect, and that there appears to 
be no work of any importance treating of them more 
recent than that of Rubio in 1853. With reference 
to the object of this work, which makes no preten- 
sion to be a complete treatise on Balneology, it has 
been deemed unnecessary to include detailed chemical 
analyses of all the waters. These will be found in 
the large manuals of Balneology, and the " Diction- 
naire des Eaux Minerales," of which a later edition is 
much wanted. Enough has been said to show the 
general composition of most of the waters. 

While I have to acknowledge the assistance I have 
derived from Constantine James's popular book, and 
Welter's little " Taschenbuch," also from a great many 
guide books and local monographs, I must also thank 
Drs. Hermann Velten and Robert Velten, of Aix-la- 
Chapelle, for some valuable hints. Helfts' "Balneother- 
apies' 1867, and Meyer- Ahren's elaborate work on the 
Swiss baths, of the same year, have been of much use 
to me. But the works that I must acknowledge my 
special obligation to, and of which I have made the 


freest use, are Braun's "Lehrbuch," 1868, written in a 
critical spirit, and Lersch's "Praktische Lehrbuch," of 
the same year, like all the other works of that dis- 
tinguished Balneologist of Aix-la-Chapelle, a perfect 
mine of information. 

I find that the task I have attempted is a less easy 
one than I anticipated, and the words of Paracelsus, 
which appeared to me at first to be extravagant, no 
longer seem so : " The knowledge of such baths is 
especially worthy of the physician, for in it are com- 
prehended not only the whole of medicine, but also 
the principles of all the natural sciences with which 
a physician should be acquainted.' , While I have felt 
the difficulty of reaching such a standard, I have often 
been tempted to contrast it with the unhesitating con- 
fidence of many a bath physician, " qui ne voit rien 
d'obscur dans la me'decine, rien de douteux, rien de 




When we come to analyse the benefits obtained from 
a visit to one of the many places resorted to in the 
search for health, we find that they are not the result of 
any one single, but of many co-operating causes. 

Take Trousseau and Pidoux's description of a fine 
Paris lady, written by the way more in the style of a 
French novelist than of staid practitioners : she is 
represented "as living in the midst of luxury, not 
getting up till mid-day, confining herself during most 
of the afternoon to a perfumed room, which the light 
scarcely penetrates, taking a drive in a close carriage 
when the weather is fine enough, living on made dishes, 
which are made the more piquant as her appetite 
grows more fantastic ; next come her passions, good or 
bad, her disposition, sad or gay, her social and family 
duties, the routine of every-day little annoyances, and 
finally ennui, that pest of idleness and of riches. Her 


appetite fails, her digestion is languid, her nervous 
system is exalted, she gives an endless deal of trou- 
ble to her doctor, who can do little for her, and who 
in despair sends her to some spa. There her habits 
are changed in every way. To begin with, she has to 
get up early in the morning for her waters, or her bath ; 
she leads a comparatively simple life in the open air; 
and without going into further details as to her changed 
mode of life, can you wonder if she returns to Paris 
cured ? " 

A well-known English author, Dr. Beale, expresses 
himself thus : " If patients could be induced to retire to 
a pleasant part of the country, where they would take 
moderate exercise, and be free from mental anxiety, 
meet with agreeable society, live regularly, take small 
doses of alkalies, and bathe themselves for an hour or 
two a day in warm water, in which some carbonate of 
soda has been dissolved, they would receive as great 
benefit as by travelling hundreds of miles away, and 
at much less trouble and expense." Here the whole 
question is begged. Is it so easy to find, just when you 
want it, a pleasant spot in a picturesque district, with 
agreeable society, and all the conveniences for bathing 
ready to your hand, and would they be less expensive ? 
Even in the case of hydropathy, the appliances of which 
are so easily procured, who thinks of going through a 
regular couise of it in his own house, or in an establish- 
ment in the town where he lives ? If he does not go as 


far as Malvern, or Yorkshire, or the Rhine, he at least 
leaves London, or any large city in which he may be, 
and retires to its neighbourhood; and when he does 
so, a portion of the benefit he may obtain is to be set 
down to the amusement he receives from the society 
he meets in the establishment, and the enforced rules 
of such institutions. 

The first of the advantages of leaving home is that 
of travelling ; on its pleasures I need not expatiate ; but 
those who travel in fine weather, and in comfort, are 
always in good spirits, and they fall in with others who 
are, with the exception of a few habitual grumblers, 
always cheerful. Montaigne said well, " He who does 
not bring along with him so much cheerfulness as to 
enjoy the pleasure of the company he will there meet, 
and the walks and exercise to which the beauties of 
most baths invite us, will doubtless lose the best and 
surest part of their effect" This social relaxation is 
as much required by the hard-worked office man, who 
goes through his routine work almost mechanically, as 
by the man of letters, or by the statesman, whose 
loftier pursuits and objects put a strain on the higher 
mental powers. It is good for us all to get out of our 
groove for a time. In travelling alterations of habit are 
enforced ; a certain irregularity of hours of rising and 
of going to bed takes the place of our fixed ways. 
There is necessarily a change of diet, and of hours 
for taking meals. 

BA TH LIFE. 1 5 

When his journey is once over — when a patient is 
settled at a bath — the routine of home habits is altered ; 
a special diet is usually enjoined, and sometimes adopted. 
Patients will often obey implicitly the directions they 
receive when away from home, who turn a deaf ear to 
the judicious, but as they think routine, advice of their 
home attendant. What does not by its novelty arrest 
the imagination is apt to be treated with indifference. 
For a long time certain absolute rules of diet were 
laid down for patients while drinking waters. Butter, 
and coffee, and tea, and many innocent articles were 
proscribed. A doctor who allowed the use of butter 
was set down as an ignoramus, just as an Eastern 
would have no opinion of one if he ordered him a 
hot article of diet, when the patient considered that a 
cold one was suitable for- his complaint. Long lists 
were paraded, and are still used in some places, pointing 
out what things may be eaten, and what are to be 
avoided. Many patients like having such positive in- 
junctions. General principles alone can be enunciated 
at a distance ; those special instructions are welcomed 
on the spot The general rule is to confine oneself 
to eating light digestible food. No one while at home, 
using laxative medicine, or indeed counting himself ill, 
would think of eating pork, pickles, salads, fruit, red 
herrings ; and every prudent man will avoid such things 
when drinkipg mineral waters, and also learn from his 
physician whether there are any special precautions to 


be taken while using the waters of a particular spring. 
At one time bathing and drinking were proscribed to 
women at certain periods, and in certain conditions, but 
that rule has been very properly relaxed somewhat 

The routine of bath life, already so familiar to 
most English readers, scarcely requires to be described. 
The drinking of the mineral waters is done mainly 
between half-past six and half-past eight in the morn- 
ing ; a glass of water, on an average perhaps of six to 
eight oz., is drunk. Many patients drink their water 
diluted with milk or whey, and ladies often suck it 
through glass tubes ; but in the great majority of 
instances these practices are unnecessary. The patient 
then walks up and down shaded alleys or covered 
ways with his friends — and in many new baths the want 
of sufficient shade is a great drawback — and repeats 
his draughts at intervals of about twenty minutes, 
until he has taken his supply, then goes home to a 
light breakfast There are some few people with such 
an inveterate dislike to early rising that they must be 
allowed to drink the waters in their homes at first 
But an effort should always be made to induce them 
to get up early. There is no objection to their taking 
a small cup of coffee, or of tea, before they go out 
of doors. When baths as well as drinking waters are 
used, the drinking precedes the bathing; most people 
who rise early get their bath over before breakfast 
But those who do not rise early, or who are not 


strong, put the bath off till after breakfast. The bath 
of course should be over before any heavy meal is 

In France you are usually supplied with two abundant 
meals, — one the dkjeuner about ten in the morning, the 
other a dinner about five o'clock. In Germany, on the 
contrary, the one great meal is taken by the visitors 
chiefly about one o'clock, and there is a later and more 
expensive meal about five o'clock, mostly frequented 
by English and French. I am satisfied, from what I 
have seen, that patients eat a great deal too much 
at these table d'hdte dinners, unless in some places, 
such as Carlsbad, where the dinner-supplies (there is 
no table d'hdte) are, to a certain extent, under the 
control of the medical men. While eating too richly 
and in too great variety is the danger of the table 
d'hote, the advantage of it is, that meeting the amazing 
variety of people seen there is useful to nervous and 
hypochondriacal, and to many dyspeptic patients. The 
well doctor should be asked in each particular case 
whether it is better to go to a table d'hote, or to 
dine at home. One matter of great importance to 
many English travellers, with whom the wines of the 
country often disagree, is that they should find out at 
once some good sound wine which they can drink 
without the risk of being incommoded by it An hour 
after dinner they go, in some places, and drink any mild 
acidulous water that the place supplies. The chief 



amusements are bands of music during the morning 
and evening, balls on certain evenings of the week, 
concerts, and theatres ; for in all the principal spas there 
are handsome public rooms, comprising magnificent 
ball-rooms and dining-rooms, theatre or concert-room, 
and reading-rooms. Excursions to places of interest in 
the neighbourhood both help to fill up the time 
agreeably, and if judiciously managed, the exercise and 
the change of air which they involve contribute to the 

These are the legitimate amusements, but at a great 
many spas, and those most frequented by the English, 
gambling is a great attraction, especially at Spa, Baden 
Baden, Wiesbaden, and above all at Homburg.* The 
gambling tables will ere long be closed, and the English 
must then manage to amuse themselves without their 
help. At present nothing is commoner than to hear 
the English complain of the intolerable dulness of Kis- 
singen, or of Schwalbach, although the scenery is pleasant, 
and cheerful company is always to be had at these 
places. It is impossible not to wish for a time when 
baths will not depend upon such factitious support, and 
it will be curious to see how a place like Homburg will 

* There are still about eight German and one Swiss and one 
Belgian spa where gambling tables are kept. The inhabitants of 
Frankfort enjoy the privilege of being within an hour's railway 
journey of no fewer than four gambling tables, — Homburg, Wies- 
baden, Nauheim, and Wilhelmsbad. 


stand the test. Pleasant places though such ones be, they 
are undoubtedly full of vice of all kinds,* and it can 
only be in the hope of working a reformation where 
it is so much wanted that personages of most special 
gravity and reverence, with many watering-places of 
equal salubriousness open to them, are led to resort 
to the gambling spas. 

The selection of the particular bath to send a patient 
to must be regulated by a variety of circumstances. 
The first, but by no means the only consideration, is 
the nature of his malady — whether you are selecting a 
place for the patient alone, or whether a place is re- 
quired that may at the same time suit some members 
of his family, or some friends that may accompany him. 
Is the patient one who requires repose and quiet, or 
does he stand in need of pleasant society? Then 
comes the question of expense and of distance. It 
is usually more convenient to select a place not very 
remote or difficult of access, although this is not always 
the case. Then, are the patients fastidious as to diet, 
and in other respects ?t Do they require, or is it wise, 

* It is amusing to read how in former times such penalties as 
public whippings at the four corners of the baths were employed at 
Plombieres to deter improper persons. 

+ My own feeling is that the English, generally speaking, are 
over-fastidious, and require too much. I believe that in many cases 
they would be all the better for roughing it a little at some of the 
smaller spas, if only the appliances in them for meeting the one 
daily-recurring necessity were improved. The simple truth is that 

C 2 


that they should have the stimulus of excitement ? Is the 
climate of the place very important for the particular 
case ? The climate in reality depends much less on the 
latitude of the place, and its absolute temperature as 
shown by the thermometer, than on its being sheltered 
from the prevailing winds, and having shady alleys near 
the wells, and paths through the forests with resting- 
places in the vicinity. Are the arrangements of the 
particular bath good? If the place is overcrowded, 
the difficulty of procuring a bath, and the necessity of 
going at 3 a.m. to take one, may do away with half 
the benefit expected from it 

Some light is thrown on these subjects by ascertaining 
how many visitors resort to particular baths ; because 
the larger a place is the greater is the number of those 
who go there merely for amusement, and vice versd. But 
it is not very easy to arrive at accurate statistics. This 
statement from Ischl well illustrates the difficulty. In the 
year 1867 Ischl was visited by 5,795 parties of strangers, 
while the number of parties that entered themselves for 
treatment was 1,199, which represented 3,100 individuals. 
Again, in 1868 the number of strangers visiting Aix-la- 
Chapelle was over 10,000, while those who underwent 
treatment were between 3,000 and 4,000. 

The following calculations will, however, give some 
general ideas on the subject of the more crowded ones. 

defective arrangements in this respect interfere most materially with 
the health and comfort of those who are accustomed to better ones. 



Homburg is probably much underrated, while I have not 
been able to obtain any returns for the crowded Schwal- 
bach, or for Vichy, the most crowded spa in France, 
where the number of guests cannot be under 25,000 or 
30,000. Nor have I any returns for the popular bath 
of St Moritz. The Spanish bath of Panticosa, of 
the same elevation, has 1,000 patients, notwithstanding 
its cramped space. 






Eastern France 


• Spa .... 
f Baden Baden . 

Wiesbaden . . 

Homburg . . 

Baden (Vienna) 

Kissingen . . 

Gastein . . . 

Carlsbad . . 

Marienbad .. . 

Franzensbad . 

Elster . . . 

Toplitz . . . 

Baden . . . 

Bagneres de Luchon 

Bagneres de Bigorres 

Eaux-Bonnes . 

Cauterets . . 

Ax ... . 

Aix .... 

Uriage . . . 







3, 000 










We thus find that the principal baths alone, some twenty- 
five out of the three or four hundred considerable baths 
in Europe, have a resort of at least 300,000 individuals. 


A great deal of the success of a visit to a spa depends 
on the patient going willingly, having friends with him, 
going to a cheerful place, being fortunate in his weather 
(although Lersch says he hears of most cures in wet 
seasons). More depends on such matters than we are 
perhaps apt to think. If a patient has taken a dislike 
to a particular spa during one year's experience of 
it, although this may have been merely the result of 
accident or caprice, it is far better to select a new 
place for him, than to force him" back to a spa he 
dislikes. Patients, again, who have extravagant faith in 
the virtues of a spa they have already tried, should 
not be rashly dissuaded from returning to it, for con- 
fidence is always an important element of cure. 

No patient ought to go to a bath without a statement 
of his case from his usual medical attendant With 
the aid of a statement the bath physician is in a much 
better position for prescribing a suitable course of treat- 
ment, than if he has first to make out the whole history 
of the case, which it may take him some time to do. No 
one should attempt to enter upon bath . treatment with- 
out consulting one of the doctors of the place. There 
may be peculiar usages and practices at the particular 
bath, the use of which may not at first sight be apparent. 
But the bath doctors have practical knowledge of the 
operation of their waters. And all men of practical 
experience know the use of the weapons they wield 
better than strangers. There are in fact many waters 


of undoubted value, where the good arrangements of 
the station and the experience of the medical staff 
make up for what they want in mineral strength. 
There are differences in the application of particular 
waters to particular cases, a knowledge of which can 
only be partially explained on general principles, and 
which is attained chiefly by empirical practice. One 
whom it is usual to class among quacks, Paracelsus, 
wrote more than three centuries ago with so much prac- 
tical sense on the whole subject, that I must quote the 
substance of what he says. After explaining that a 
bath physician should be thoroughly acquainted with 
his profession, and that the virtues of wells are best 
tested by the cures they produce, for daily experience 
is worth more than the counsel of books, he says that 
the physician should regulate the diet of his patient 
according to the nature of his malady, and that a 
physician in sending a patient to a watering-place 
should judge and discriminate in what condition a 
patient is more or less fitted for a course of waters, 
and whether it is a fitting time to send him. For if 
these things are neglected patients are misled, and the 
operation of natural thermal waters falls into disrepute. 
It is a very general notion that baths and mineral 
waters, if they do you no good, at least can do you no 
harm; and this seems to have been the opinion of 
Montaigne — but he only used the indifferent, or nearly 
indifferent waters of Plombieres, Baden in Switzerland, * 


and Lucca. Not that even they can be used indiscrimi- 
nately. It is quite a mistake : many of the waters are 
very powerful medicinal agents, and may prove most 
injurious if carelessly employed. 

It was formerly the practice that patients should 
undergo a preparatory course of treatment. Boileau 
wrote a deplorable account of himself to Racine : " I 
have been purged and bled, and have not failed to 
comply with all the formalities required before com- 
mencing the use of the waters. The medicine which I 
have taken to-day has, as they pleasantly say, done me 
all the good in the world, for it has made me faint four 
or five times, and rendered me so weak that I can 
scarcely stand." But though these lengths are not gone 
to now, the less done in this way, except to improve 
the health of the patient generally, the better. Then 
the length of a cure has been usually fixed at about 
twenty-one days, especially in the use of baths ; any 
such period is purely arbitrary; in regular medicine 
no one defines the period required for cure. Paracelsus, 
to quote him once more, said that no certain and precise 
number of baths could be fixed on. Everything depends 
on the kind of baths or waters used, on the nature 
of the malady treated, and on the individual peculiarity 
of the case, whether the patient's constitution or other 
circumstances, such as the time that he can afford to 
spend. The great rule is not to hurry the cure; to 
spend as much time on it as possible ; to take the waters 


first in small quantities. Small quantities taken over 
a protracted period do not produce the disagreeable 
effects of over-dosing, and they affect the constitution 
more favourably and lastingly. Over-bathing, remaining 
too long in the bath, or bathing more than once a day, 
are practices to be avoided. 

Systematic rules about what are called after-cures have 
frequently been laid down. It is often useful, parti- 
cularly in certain classes of disease, to continue at home 
for some time the use of the waters which have been 
drunk at a spa, especially if they be of a class that 
does not suffer much when bottled and carried; or it 
may be expedient, after a lowering course of treatment 
at one well, to send a patient to another source with 
bracing properties ; a familiar instance of this is sending 
patients to iron waters after a course of saline treat- 
ment In many instances where patients have not 
benefited as much as was expected, they are dismissed 
to their homes with the assurance that they will feel 
the benefit of their bath course afterwards. This 
appears to me to be rather poor comfort. If a favour- 
able change does take place, it is by no means plain 
that the waters should get the credit of it. It is better 
to admit that waters, like all other remedies, fail at 
times to be of use. But it is often difficult to form 
a dispassionate judgment on those matters. For in- 
stance, of two patients who were last year at Aix and 
Vichy respectively, the one thought himself very little 


better while under treatment, but has been better this 
winter than for a long time. The other benefited much 
at the time, but shortly after his return home had an 
attack of disorder of the kidneys, which was attributed 
to the system being saturated with the alkalies of the 
Vichy waters. As to the question of expense it is diffi- 
cult to say much. The most fashionable baths are 
naturally the most expensive; but even at them there 
are ways of living economically, though perhaps not 
found out immediately by English not accustomed to 
foreign life. Many of the baths are very cheap places 
of residence; and altogether living, even at the best 
hotels, is considerably cheaper than in second rate 
ones in England. The kinds of cases to be sent to 
particular kinds of baths are mentioned afterwards; 
here it is not necessary to say more than that it is 
cases of chronic disease, which are but little influenced 
by ordinary medical treatment, that profit most by the 
use of mineral waters. 

Some of these are — general anaemia and chlorosis, 
scrofulous and tropical cachexy, certain urinary, biliary, 
and skin complaints, dyspepsia and hypochondriasis, 
chronic rheumatism and gout and thickened joints, 
many nervous affections, and some forms of paralysis, 
Bronchitic affections may be frequently benefited ; 
women suffering from various functional derangements 
often gain much; but ladies must not implicitly believe 
all the wonderful stories they are told of the dispersion 


of ovarian and of other tumours. If they do so, they 
will assuredly be disappointed. 

An objection which has been taken against bath cures 
may be noticed here. It has been said that the effects 
are not permanent — that one visit to a bath always 
leads to a second. But this is no real objection. There 
are few chronic complaints that can be permanently 
cured in a month or six weeks, so as to make their 
recurrence unlikely ; and his return to a bath shows 
that the patient thinks he has benefited by it, or that 
he likes it. On the same grounds the climate of the 
Himalayas might be found fault with. In India, all 
classes, from the Governor-General downwards, prefer 
spending certain portions of the year away from the 
plains ; and it is notorious that if an officer once sends 
his family to the hills, he has to do so every year. 
But the Himalayas or the Neilgherries are not less 
valuable health-resorts on that account. 



Change of air is one of the most favourable influences 
under which a patient places himself in leaving home. 
There is something in the feeling of change of air that 
is readily perceived, but not so easily described or 
explained. The mere change in the physical qualities 
of the air inhaled is too slight to afford a satisfactory 
explanation. Perhaps the best illustration of the sensa- 
tion is the intense feeling of delight and refreshment 
which a patient derives from his first drive into the 
country after a severe illness, or the first sniff of sea 
air to those who delight in it. I have never myself 
experienced any change of air So wonderfully exhi- 
larating as that from the furnace blasts of the plains 
of India to the cool air of the mountains, to the 
odour of pine forests and to the rippling of mountain 
streamlets. Existence down below and up above were 
existence in different worlds. In a case like this the 
main physical and tangible causes of these agreeable 
sensations, the change in the temperature and in the 
lightness of the air, are plain enough ; but it is by no 


means always easy to explain, not only why change of 
air is, especially in the tropics, one of our most active 
curative agencies, why any change of air is agreeable to 
most people, but how the air of particular places seems 
to suit the requirements of particular individuals, how so 
many make up their minds that the air of some places 
agrees with them and that of others disagrees with 
them ; and this not merely in the case of such seemingly 
capricious diseases as asthma. It would be convenient 
if we could believe with many of our patients, and as 
they may have been rather heedlessly told by their 
medical men, that a place suits them owing to the 
quantity of ozone, or of iodine, or of iron, or of elec- 
tricity in the air, earth, or water of the place, as it 
may be ; although there is no question that certain 
conditions of soil have a very positive influence on 
health. Patients are very naturally anxious to have a 
reason assigned for their feeling well or ill; and if a 
patient once takes up a notion about his own constitution 
or the climate of a place, it is wonderful with what per- 
tinacity he adheres to it. Although, however, we cannot 
entirely explain the cause of the difference in the effects 
in the air of different places, yet some of the general 
phenomena of different kinds of air have been tolerably 
well ascertained. 

One of the advantages in point of air gained by going 
to visit a spa, is that you usually visit it at its best 
season. If you are in the North of Europe, you go 


south to enjoy the milder climate of Central Europe ; if 
you are in Italy or in the south, you go north to avoid 
the extreme heat. It is admitted on all hands that fine 
weather acts beneficially on mankind (of course weather 
may in Europe sometimes be too hot and dry), and, 
if in going in quest of health you secure good weather, 
you have one great element in your favour; but it 
should be noted that liver and nervous cases should 
avoid the heat which suits gout and rheumatism. The 
bath season usually extends from the beginning of June 
to the end of September;* but some of the Pyrenean 
or Spanish baths, where they have two bath seasons, 
also Aix in Savoy, and certain of the Italian ones, may 
be visited earlier; and some of these, such as Ischia, 
may be used the whole year round. There are obvious 
reasons why spas cannot be so conveniently visited in 
winter as in summer ; but many baths may be easily 
used throughout the year with advantage, if patients 
will live in winter in the houses that contain their 
baths. The great value of fine weather to a patient 
consists in his being able to be constantly in the open 
air, and this ensures both a certain amount of exercise 
and of exposure to light In England we scarcely 
appreciate the advantages of this sufficiently. But be- 

* On one occasion, going to visit a bath on the 15 th September, 
the official date for its closing, I met most of the bath guests and 
their two doctors coming away in carriages. All the postal 
arrangements I found ceased on that day. 


sides the fine season there are two other important 
changes of air often met with by going to watering- 
places — the change to mountain and sea air. These 
subjects can be only very lightly touched on here — to 
do more it would be necessary to write a treatise on 
climate ; but it is necessary to glance at them in their 
general relations to our subject. 

The great characteristic of mountain air, besides its 
being cooler than the air of the plains, is its lightness, 
from the great diminution of atmospheric pressure at 
high altitudes. In the mountains there are greater and 
more sudden changes of barometric pressure than in 
the plains, more rain and wind, although in the very 
highest ranges the quantity of rain is not so great as 
in the lower ones; on the whole, more alternation of 
movement and of repose in the air. There is more 
absolute moisture of the air above than down below, 
and the air, from its rarefaction, has more capacity for 
taking up moisture. Like all country air, it contains 
fewer organic or other impurities than that of towns. 
There is increased light and greater sun radiation; as 
the soil is more easily heated during the day, so is it 
more readily cooled at night On the whole, the daily 
and yearly range of temperature is more regular and 
less extensive above than in the plains. 

But the qualities of mountain climates do not 
depend simply on elevation. Montreux is considered 
to have an alpine climate, though only 1,100 feet 


above the sea. They are subject to many local in- 
fluences ; for instance, valleys of the same elevation as 
plateaux or spurs of mountains vary much more in tem- 
perature than the latter. The position of a hill giving 
shelter from the north, the opening of one valley into 
another, or the bendings of a valley, all influence the 
local climate. Spurs of mountains are colder than valleys 
when they are exposed to the north, warmer if they face 
the south, east, or west. Isolated mountains have less 
variation of temperature than plains. The neighbourhood 
of glaciers, snowfields, lakes, and even of cultivated 
land, lowers the temperature of a place. The number 
of hours a mountain valley is shone on by the sun 
influences its temperature much. Valleys are in winter 
colder, in summer warmer, than the mountains. It is 
a common notion that electrical phenomena are very 
violent in mountains, but this is mainly owing to the 
reverberation of sound among them. But enough has 
been said to show that mere meteorological tests can 
show but very imperfectly what a mountain climate 
really is. Its effect on the system must be gathered 
from observation. 

Travellers have often described certain effects of the 
air at great elevations, such as accelerated action of 
the heart, and bleeding at the nose or ears;* and I am 

* These symptoms have usually occurred in those who have 
exhausted themselves in the ascent of mountains, and violent head- 
ache and sickness sometimes follow a descent from a great height 


aware that giddiness and headache and incapacity for 
exertion have been said to be met with in Europe at 
5,000 and 5,700 feet, and lower. But they need not be 
discussed here, as no such unpleasant effects (nothing 
more than a little nervous excitement or sleeplessness 
at first) are experienced in India up to 8,000 feet, which 
heights the English fresh from the plains reach without 
the slightest inconvenience, and at which they have long 
lived comfortably in the Himalayas. Not even the 

It seems scarcely fair to attribute them to the rarefaction of the air, 
when we find that observers in balloons at the height of 23,000 
feet, from whom a half atmosphere's pressure was taken off, 
experienced only acceleration of pulse and of respiration. When 
Glaisher rose to about 30,000 feet, and about two- thirds of an atmo- 
sphere's pressure was taken off, he suffered mainly from the effects 
of extreme cold ; and going in the opposite direction, if we consider 
the case of divers, they can bear the most enormous pressure with 
no disturbance of their functions beyond a little singing in the ears. 
Divers using the latest French apparatus sustain at the bottom of 
the sea the pressure of a column of 120 feet, equal to five atmo- 
spheres ; and they have absolutely worked, although it is not 
counted safe to do so, at 150 to 180 feet, or under a pressure of 
seven atmospheres. It is considered prudent to descend, and still 
more to ascend, gradually ; otherwise there may be headache and 
singing in the ears. (It is strange that increased and diminished 
pressure in the first instance produce similar effects.) Under these 
circumstances, and knowing that one can cross the St Gothard, a 
height of nearly 8,000 feet, and the Stelvio, over 9,000, without 
any disagreeable feelings, we cannot expect the assumed effects of 
rarefied air to be manifested at our most elevated European health- 
resorts, as St. Moritz, where only about one-sixth of an atmosphere 
is taken off. Once, however, tell a nervous patient that he is to 
experience unusual sensations, and he is sure to feel them. 



highest places of health-resort in Europe reach that 

Unfortunately little is known exactly of the operation 
of mountain air. Professor Pettenkofer has favoured 
me with these general observations on it : " Rarefaction 
of the air and decrease of temperature stand in a sort 
of antagonism to each other in their operation. Rare- 
faction of the air develops the surface circulation, while 
the simultaneous diminution of temperature and in- 
creased cutaneous transpiration tend to repress it" He 
states, "that the frequency of the pulse and of respi- 
ration cannot be very different, unless the degree of 
atmospheric pressure is very different. We breathe to 
take up a certain amount of oxygen, and to give out 
a certain amount of carbonic acid. The quantity taken 
in and given out depends much more on the quality 
of the blood, and on the change of tissue, than on the 
absolute quantity of air which an inspiration contains. 
It is proved, experimentally, to be an error to suppose 
that in an atmosphere containing more than the usual 
amount of oxygen, more oxygen is also taken up by the 

According to the analogy of experiments made in 
balloons and with compressed air, it has been thought 
likely that the pulse beats faster, and that respiration 
is quickened. But although this may in the beginning 
of a stay in the mountains have an alterative effect on 
the processes of respiration and of nutrition, the system 


soon gets accustomed to the change. It seems certain 
that the higher capacity of mountain air for moisture 
favours the expiration and perspiration of water, also 
that the air being thinner, less oxygen must be inhaled 
at each inspiration unless the lungs take on an increased 
action, that if the supply of oxygen is defective, there 
must be an expansion of the lung- cells to make up for 
it. The only practical information that we have on the 
subject (the question ought to have been settled long 
ago in our Indian hill-stations) is that of Coindet in 
Mexico, who found at a height of 7,410 feet that the 
average number of respirations of 250 Frenchmen was 
19/30, and of the same number of Mexicans 20*29 P er 
minute, with relative pulses of 76 and 80. While, there- 
fore, the respiration was slightly more frequent, there 
was no alteration in the relation between the circulation 
and respiration. He found the absolute quantity of 
carbonic acid expired the same as in the plains, and 
this is supported by the analogy of Professor Frankland's 
interesting experiment, showing that the amount of com- 
bustion of a candle was almost the same on the summit 
of Mont Blanc as at its base. 

The general view of the subject is that change to the 
mountains retards oxidation, i.e. animal waste, and is 
therefore conservative ; also that changes of barometric 
pressure and of moisture of the atmosphere are bene- 
ficial in giving the system alternate periods of excite- 
ment and of rest. But on all these subjects there is 

d 2 


little positively known. Though some sensitive organi- 
zations are undoubtedly affected by every change of 
barometric pressure, or by what it represents, the gene- 
rality of men either are influenced in no palpable way 
by it, or immediately accommodate themselves to it. 

Alpine climates have been divided somewhat arti- 
ficially into various zones, and their effects have been 
characterised as tonic and vivifying, tonic and exciting, 
&c. ; but such divisions are at best dependent on latitude 
and on local influences. To those who are familiar 
with a lengthened residence in the Himalayas, or who 
think of the elevation of Mexico and other inhabited 
parts of the world, some European directions appear 
amusing. Thus it has been laid down that patients 
must not stay more than from six weeks to two months 
at heights of from 3,700 to 4,600 feet. At 3,000 feet 
you may stay some months ; at 1,500 to 1,850, the 
greater part of the fine season. 

It is by no means easy to get very satisfactory 
evidence as to the health of residents in hill countries. 
In the lower parts of the Swiss mountains, dysentery 
seems to be common, just as it is in the Himalayas, 
and as diarrhoea is frequent in the Pyrenees, and low 
fevers are not absent. Sometimes a wonderful immunity 
from eruptive fevers is reported ; but that is mainly, 
no doubt, from isolation. But of late years it has 
been attempted to prove : that consumption does 
not occur above certain elevations. While there is 


little doubt that certain elevated spots enjoy a con- 
siderable amount of immunity from the disease, it would 
be easy to show that this is also the case with various 
places at the level of the sea. Consumption un- 
doubtedly occurs among the natives of the Himalayas, 
and is not infrequent; and among the children of 
Europeans in the Indian hills, acute chest and espe- 
cially laryngeal attacks are common. To look at a few 
places in Switzerland : tuberculosis is said not to be 
common at Interlachen, a height of 1,700 feet, and still 
less frequent among the true hill people. At Gais, 2,875 
feet high, there is a good deal of phthisis and rheu- 
matism ; in the valley of Chateau d'Ex, 2,900 feet, 
consumption is common. At Leukerbad, 4,400 to 
4,600 feet high, inflammations of the chest are a very 
common cause of death. At Davos, 4,700 feet, lung 
inflammations are common, but mild, and there is no 
endemic phthisis. At St. Moritz — and the country 
saying as to the Upper Engadine is, that it has nine 
months* winter and three months cold — it is said that 
phthisis is unknown. It does not however follow, 
because there may or may not be a good deal of 
consumption in a place, that it is unsuitable, or the 
reverse, as a change to a consumptive patient. I 
would only say that mere elevation is no sure test 
of the healthiness of a place. Munich, some 1,500, 
and Madrid, some 2,000 feet above the sea, are any- 
thing but particularly healthy cities ; and for the present 


it seems to be a pedantic assumption to talk of living 
within or above tubercular zones. 

As to the therapeutic action of mountain air, very 
differing opinions have been expressed. While it has 
been usually believed that it is a valuable remedy in 
anaemia, some have even thought that it induced that 
condition. Others consider that it produces congestion, 
and a tendency to haemorrhage. Still I think that I 
am warranted in saying that practically mountain air 
is of all the most tonic and bracing, and particularly 
suited for convalescence from acute disease or loss 
of blood — for much the same cases as are benefited by 
quinine and iron. The question of how far mountain 
climates are suitable for consumptive patients is at 
present exciting much interest, and it is not a little re- 
markable that abroad (for English consumptive patients 
are seldom sent to spas) many of the favourite places of 
resort for such patients have for some years been baths 
situated at very considerable elevations. Gorbersdorf in 
Silesia, a hydropathic establishment, 1,700 feet high, is 
not only advertised as being above the tubercular zone, 
but is a considerable place of resort for this class of 
patients. . Eaux Bonnes in the Pyrenees, 2,100 feet, 
and Mont d'Or in Central France, 2,900 feet, have long 
been favourite stations. Consumptive cases have begun 
to winter at Davos, 4,700 feet, and even at the favourite 
St. Moritz, 5,700 feet While Davos, where there is no 
well, is in high repute, it is curious to observe that at 


the neighbouring baths of Tarasp and Fideris, one 500 
feet, the other 1,500 feet lower, it is stated that con- 
sumptive cases are unsuitable for them. The Spaniards 
have long sent such cases to Panticosa, of equal altitude 
with St. Moritz ; and I have recently heard of great 
improvement in some cases of haemoptysis at that place. 
On the other hand Rigischeideck, an exposed station 
at the height of 5,000 feet, is found injurious to phthisis, 
and authors generally reckon such climates unfavourable 
in haemoptysis. 

Much further observation is wanted on these sub- 
jects, and it may be required to modify the old view 
that mountain climates are necessarily unfavourable to 
all forms of consumption. In India, it used to be the 
established practice never to send phthisical cases to 
the Himalayas, any more than cases of disease of the 
heart or large blood vessels. But as to the former 
class of patients this rule has been somewhat relaxed, 
and without bad effects, if not with striking benefit 

Cases of pulmonary phthisis are usually divided into 
two types — a commoner one, the torpid or lymphatic, 
and the more irritative or erethic form (which, how- 
ever, supervenes towards the termination of the other 
form also) ; and corresponding climates, one favourable 
and one unfavourable to each state, have been defined 
rather arbitrarily. The first type would be considered 
the best suited for mountain climates, which in all 
probability are more useful in strengthening the con- 


stitution in early years, and in warding off phthisis, than 
in combating the disease when once established. 

As to other forms of disease benefited by a mountain 
climate, dyspepsia is often relieved by it; appetite is 
frequently almost instantaneously restored, but these 
effects are not always permanent. 

In Europe, on the idea that a more active circulation 
relieves congestions of the abdominal viscera, moun- 
tain air has been talked of as a certain cure in obstruc- 
tion of the liver and of the spleen. But Indian 
experience would make one slow to endorse these 
opinions, or to expect much if those organs have under- 
gone any considerable change. Nor is Indian experience 
in accordance with the European notion, that a hill 
climate is useful in dysentery and in diarrhoea. Some 
of the worst forms of diarrhoea are endemic in some 
of the Indian hill stations. After all, it is for cases of 
general debility, of slow recovery from child-bearing, 
or from protracted lactation, in anaemia and chlorosis, 
in women and in children, that the beneficial effects 
of mountain climates are most apparent. 

Diseases of the heart and large vessels and bron- 
chitis are admitted by all to be unsuitable for the 
mountains, and haemoptysis is by most writers. 

When it is intended to send patients to mountain 
climates, it may sometimes be necessary, but scarcely 
in the case of English, to ascertain the elevation of a 
patient's home. Thus a patient sent from Munich or 


Innspriick to Ischl or Reichenhall might benefit by the 
change, and by their sub-Alpine climate, but the benefit 
would not be derived from any superior altitude of 
these places. 

Although, curiously enough, scarcely a single well 
of any importance, except one in the extreme south 
of Europe, is situated close to the sea, yet, as sea-air 
forms an important element in the effects of sea- 
bathing, it may be well to say a few words concern- 
ing it 

As there is the least barometric pressure at high 
elevations, so there is the greatest at the sea-level. Its 
variations are also greatest there. The temperature 
of sea-air is on the whole lower than that of land- 
air, and is less variable. If the summer heat is not 
so great, so also is the winter cold not so intense as 
in inland situations. Owing to the surface evaporation, 
the absolute moisture of the sea-air is somewhat greater, 
and the rainfall is greater on coasts than in interiors. 
It is freer from organic impurities than land-air, and 
contains more particles of common salt. It also con- 
tains a good deal of ozone, a form of oxygen about 
which wonderfully little as to its operation on man is 
known with certainty; any quantity of iodine that 
may be present in 4 the air is much too small to have 
an appreciable influence on man, and the smell of it 
in sea-air, often talked of, is no doubt mainly derived 
from the seaweed when the tide is out. It has been 


thought by some, that with the greater atmospheric 
pressure more carbonic acid is expired from the lungs 
at the sea-side, the inhalation of oxygen thereby 
increased, and"* the processes of blood-making and of 
nutrition thus quickened. However, it is not likely that 
there is much difference in the quantity of carbonic 
acid expired. Experiments have seemed to show that 
sea-air produces, almost immediately on arrival at the 
sea-coast, a great increase both of retrogressive and of 
progressive change of tissue, as manifested by a striking 
increase in urea and diminution of uric and phosphatic 
acids in the renal secretion, in greatly increased desire 
for food and remarkable augmentation of the weight of 
the body. To use simpler language, to the great 
majority of men a change to sea-air is bracing and 
invigorating. It exercises, very probably owing to its 
increased moisture, and very possibly owing to the 
saline particles it contains, a favourable influence on 
most bronchial affections, and in diseases connected 
with defective nutrition, especially in early years. Sea- 
air must be one of the agencies which make sea-voyages 
so useful in chronic diarrhoea and dysentery. 

Places on the sea-coast, whether in England or in 
France, have long been the favourite resorts of people 
with delicate chests, or of a strumous habit of body. 
And although many German writers do not advo- 
cate the air of sea-coasts in such cases, I believe that 
up to the present time nothing better can be recom- 


mended in threatened phthisis, in bronchitis, some 
forms of disease of the kidneys, and of rheumatism, 
than such places ; and, in case of natives of the North 
of Europe, they are sent with great advantage during 
winter to some of the many places in the South — most 
of them near the sea-coast, and chiefly that of the 

There is ample scope for selection among these 
places, and there is an absurd amount of fashion which 
often determines the popularity or otherwise of a new 
place ; much petty refinement about shades of climate. 
A new station is spoken of like a new medicine. Un- 
naturally sharp lines of demarcation are drawn between 
the various forms of lung disease, and between the 
different climates suited to each. Pau and Arcachon, 
Hyeres, Nice, Cannes, Mentone, and Ajaccio, one of 
the latest found, have each many points to recommend 
them ; so also have Valentia, and especially Malaga — 
Malaga being not very far from one of the most fre- 
quented springs in Spain ; Spezzia and Pisa in Italy, and 
Palermo in Sicily, if a patient cannot visit Egypt or 
Algiers, or the now rather neglected, because out of 
the way, island of Madeira. It is far more important 
than settling minute differences between allied climates, 
and pronouncing positively on imperfect data this air 
to be bracing, that relaxing (and patients are taught 
to expect stimulating or depressing effects), to select a 
place with such a winter climate that a patient can be 


as many hours as possible in the open air, one which is 
tolerably cheerful, and in which he will not see too 
many sick faces; above all, one in which comfortable 
lodgings and good food are to be found, for without 
them, and unless he will make up his mind to live 
as an invalid, a patient, if his case be at all advanced, 
had better remain at home. I have little doubt that 
such places with their sea-air, though some are not 
actually on the coast, are far better adapted for cases 
of phthisis and of bronchitis than inland places, such 
as Montreux at the east end of the Lake of Geneva, 
or Meran in the Tyrol, the last of which is the great 
winter resort of Germans, and still better than any 
baths with their inhaling apparatuses and other appli- 
ances, unless such places as Amelie les Bains, with a 
very mild winter climate. 

But a sea-voyage presents the most complete oppor- 
tunity of freely inhaling the sea-air ; and the immunity 
of sailors from chest complaints is remarkable. There 
is a considerable variety of opinion as to the amount 
of advantage to be derived from sea-voyages. I am 
inclined to believe, from personal observation, that young 
people from fourteen to twenty have often derived great 
benefit from long sea-voyages in warmer latitudes ; and 
that even at more advanced years, when patients 
have what are called delicate chests, and there is merely 
a suspicion that phthisis may set in, the disease has 
been frequently warded off by a voyage. If the disease 


is at all advanced, a voyage may still, like most changes 
of place, help to prolong life. Sea-air is an important 
element in the sea-side cures of scrofula, but more will 
be said respecting that condition of system under the 
head of sea-baths. Almost the only contra-indication 
to sea-air appears to be in cutaneous, and in some 
bronchitic and asthmatic affections. It would be in- 
teresting to ascertain whether the common impression 
that sea-air is injurious in skin complaints is really 
well founded. 

After what has been now said of the effects of 
mountain and of sea climates, no one can fail to 
remark that they have been recommended in the same 
classes of disease, in recovery from acute illness, in 
anaemia, in scrofula, and in consumption. There may 
be indeed some difference of opinion about the last ; 
most authors have advised for it the level of the sea- 
side, others the aromatic air of the steppes of Russia ; 
others .think it wiser that patients should go to high 
ground, but not above 2,500 or 3,000 feet in Europe ; 
while the latest view is that they should be at least 
2,000 feet higher up. Still, in all these recommenda- 
tions the same advantages are looked for from such 
very different conditions of atmospheric pressure and 
of temperature, that fresh study of the subject and 
a new analysis of the agencies in force are urgently 

Before leaving the subject of mountain and sea air, I 


may add that, in many cases where the reactive powers 
of the system are not much impaired, while gout is 
flying and not yet fixed, when only a short absence 
from home is possible, the mountain-air of our own 
islands (a visit to which often involves a sea-voyage 
also), aided by the active exercise which a sportsman 
must take, will often prove more efficacious than 
a hurried visit to a foreign spa — nay, I have heard 
of ladies suffering from simple debility, profiting more 
by the air of Braemar than by the iron of Schwalbach, 
although the elevation of the latter only falls 200 or 
300 feet short of that of the former. I have known 
a German lady, a great traveller, reach Braemar and 
be so satisfied that she had at last found an air to 
suit her, that her family had difficulty in getting her 
to leave it. 

I have thus imperfectly sketched the general operation 
of sea and of mountain air, without pretending to 
examine minutely the operation of hot and cold, dry 
or damp air, first on respiration, and second on 
the skin, and through them on the temperature of 
the body; but I cannot quit the subject of atmo- 
spheric air without alluding to two of its popular 
applications — hot air, of which we have a natural 
example at Testaccio in Ischia, and compressed air. 

The first of these, dry hot-air baths, differ from 
vapour baths in not impeding the circulation as the 
latter do, by depositing moisture in the bronchial tubes. 


The lungs, instead of having, as they usually have, to 
heat up the inspired air, are subjected to a tempera- 
ture above their own. Hot-air baths favour perspiration 
in the greatest degree; while vapour baths, from the 
quantity of moisture already present in the air, retard 
it In using the hot-air baths now so popular through- 
out Europe (and of which there are many modifi- 
cations), the patient goes first into the tepidarium, 
which has a temperature of 113 to 117 , in which 
he remains naked, and at rest, until the perspiration, 
bursting forth, begins to form drops, or 25 to 40 
minutes. He next proceeds to the hottest room, or 
sudatorium, of a temperature of, say, 133 , and remains 
there till the perspiration runs down the skin, or 12 
to 18 minutes. A servant then, by means of a 
woollen glove, rubs off the perspiration, and next 
kneads all the muscles for 4 to 6 minutes. The 
patient next proceeds to the lavacrum, where he has 
water poured over him of the temperature of 8i° 
to 86° ; next the whole body is soaped over, the suds 
rubbed off, and the patient betakes himself to the 
frigidarium, where he lays himself on a couch, still 
unclothed, and waits till his skin is completely dry; 
this last measure may last 25 or 30 minutes, when he 
dresses and leaves the bath greatly refreshed. 

Under this head would come the hot-air baths so 
readily procured by means of a spirit lamp, although 
in this case, as indeed in the hot-air bath just 


described, there is always a certain amount of vapour 
present. There is no readier way of inducing profuse 
perspiration when it is desired than by them, and in 
their use the stimulating effect of dry air on the lungs is 
avoided, as its operation is usually confined to the skin. 

At this moment hot-air baths are in great vogue, 
and gladly resorted to by patients, when it is explained 
to them, that their maladies are caused by "Certaines 
humeurs qu'entre nous autre savants nous appellons 
humeurs peccantes." But they often cause exhaustion, 
and are not to be lightly prescribed to those who 
have reached middle age. Something more will be 
said afterwards of them. 

Compressed air. — Many baths, such as Wiesbaden and 
Reichenhall in Germany, various, establishments in 
France, and, I believe, some hydropathic ones, as at 
Malvern and Ilkeley in this country, have compressed 
air apparatuses. They resemble a huge diving-bell, with 
partitions in which the patients place themselves. The 
chief palpable feeling to the patient is a certain amount 
of ringing in the ears, and it seems to be ascertained 
that the frequency of the respiration and of the 
pulse is diminished considerably. It is certain that 
compressed air brings a larger quantity of oxygen to 
the lungs, but the question is not settled as to what 
comes of this oxygen; whether the surplus which 
does not find employment in respiration, combines 
directly with the tissues. Dr. Liebig of Reichenhall 


has now been for some years engaged in investigating 
this question, and the amount of carbonic acid exhaled 
which is involved in it, and also the mechanical altera- 
tions it produces in the process of respiration : a fresh 
contribution of his on this subject may be shortly 
expected. Patients remain from one hour and a half 
to one hour and forty minutes in the apparatus, during 
one hour of which they are exposed to the constant 
pressure of one and a half atmosphere. The remaining 
time is occupied in raising and in lowering the pressure. 
In these experiments Dr. Liebig says he has frequently 
been for a considerable time under increased atmospheric 
pressure, and it was pleasant to be able to observe in 
his own person both the suppression of fresh catarrh 
of the air-tubes, and also the agreeable and quickening 
effect of the pressure on his general sensations. The 
pressure was increased to one and three-quarter atmo- 
sphere, and he found his sensations still pleasanter than 
under the usual pressure of one and a half atmosphere, 
but it is known that labourers can work without any 
inconvenience, except a noise in their ears, under the 
pressure of two atmospheres and more. The inhalation 
of compressed air seems to increase the vital capacity of 
the lungs by mechanically expanding them, and it will 
be a very interesting fact, if future observations shall 
confirm it, that the retardation of respiration is not 
merely temporary but lasts for some months. Meantime 
compressed-air baths are said to be useful in loss of 



voice, in chronic bronchitis, and the results of pleuritic 
attacks, especially so in catarrhal deafness, and even 
in chlorosis and anaemia. What seems to be tolerably 
ascertained is, that they have been of considerable use 
in some cases of asthma; but in that affection what 
remedy has not failed, and what has not seemed to 
succeed? On the whole I do not think it likely that 
compressed air will be found to be a therapeutic agent 
of much importance. 



Although most mineral waters are valued more highly 
for purposes either of bathing or of drinking, yet there 
are few spas at which both drinking and bathing are not 
practised. The one is usually made to supplement the 
other. If the mineral water is not of much efficacy 
internally, some imported water from a different source 
is drunk, and, on the other hand, arrangements are 
made to supply the deficiency, if the waters are not 
considered efficacious in baths. We shall first consider 
baths; and as their primary action is exerted by the 
action of heat and cold, through the medium of water, 
on the cutaneous surfaces, we must first say a little 
of common water, and analyse its effects as it is 
applied either hot or cold. 

The first use of bathing water is simply as a detergent 
to remove any impurities from the surface, keep the 
skin clean, and prevent the pores from being clogged 
by their own secretions or other impurities. 

But a question of much importance in the solution 
of the theory of the operation of bathing is, does the 

E 2 


skin absorb water? This is the popular belief; and 
the story of shipwrecked sailors relieving their thirst 
by wrapping themselves in cloths dipped in sea-water, 
has become a standard one. Such a measure might, 
however, granting the facts, give relief to the feelings 
in various ways, without any actual imbibition of water ; 
and the result of the most carefully conducted experi- 
ments of late years would seem to make it very doubtful, 
whether any water at all is absorbed by healthy cuta- 
neous surfaces, even after continued immersion. Clemens, 
perhaps the latest authority on the subject, thinks that 
he has proved that a full-grown man, after a twenty 
minutes' bath at a temperature of 88° to ioi°, takes 
up 4J to 6 drachms of water, not much over half an 
ounce ; and he thinks that most water is absorbed, 
when the temperature of the bath is from 94 to 105 . 
But if no amount of water, that can be considered 
to have any effect on the current of the circulation, is 
absorbed, there is no doubt as to the powerful influence 
of water on the capillaries of the skin, and the mode 
and extent of that operation depend primarily on 
the temperature of the fluid ; for the influence of the 
mechanical pressure of the water of a bath, which 
has been calculated at nearly one pound on every 
square inch of the surface, has never been determined. 
Baths must therefore be considered according as they 
are hot or cold. It would be impossible here to discuss 
the influence of heat and cold on the system — the ab- 


straction of heat from the system, and the means which 
it employs to make up for its loss ; but it may be well 
to point out one or two general facts, that the human 
system bears changes of temperature of air much better 
than of temperature of water, and can adapt itself 
therefore to very various climates. But with water it is 
different; while the temperature of the air at 75 is, 
perhaps, almost too warm for the feelings of many, 
a continued bath at that temperature is felt to be cold, 
and is depressing. On the other hand, a bath of 98 
to 10 2 acts far more excitingly than air of the same 
temperature, both because, being a better conductor, it 
brings more heat to the body, and because it suppresses 
the cutaneous transpiration, which is greatly increased 
by air of the same temperature. It may also be men- 
tioned here, that a temperature of 88° to 95 has been 
found to be the temperature of indifferent baths, such 
as can be borne longest by most men. We must now 
examine the effects of a cold bath on the system. 

Cold Baths* — The effects of a cold bath — the tem- 
perature not being below 50 — are shortly these : a 
diminution of the temperature of the skin, and of the 
subjacent tissues and blood; a certain feeling of shock 

* I may remark in passing that Sir John Floyer contributed much 
by his writings to the revival of the cold bath in Europe, although 
he rode his hobby so hard as to attribute what was thought the 
recent appearance of rickets in England to the abandonment of 
the practice of total immersion in baptism. This was about the 
year 1700. 


diffused over the whole surface, and, if the cold is 
intense and prolonged, inducing a certain amount of 
numbness of the skin. It becomes pale, and its capil- 
laries contract The action of a cold bath on the 
central organs is referable to the brain and spinal 
system, to the lungs and heart, as manifested by the 
tremor of the limbs it produces, along with a certain 
degree of oppression of the chest and gasping for 
air, while the pulse gets small and sinks. After a 
time reaction takes place, bringing redness to the 
skin and an increase of temperature. 

The colder the water is, and the more powerful and 
depressing its effects, the quicker and the more active 
is the reaction. After reaction, the bath may be con- 
tinued for some time, provided the water is not extremely 
cold; very cold baths (anything below 50 ) cannot be 
borne long, and must be concluded without waiting for 
reaction. If the bather remains quiet, and the water is 
not agitated, the portion of the water in contact with 
the skin has its temperature to a certain degree raised 
by the heat of the body, and the stimulus is less; 
but if it is agitated or changed, so that fresh cold 
water is applied to the surface, fresh stimulus and re- 
action follow. 

The effects of cold water on the human frame have 
been studied since the days of Priessnitz with a degree 
of minute observation never before bestowed on them; 
and the principles of rational hydropathy are now so 



- - -- — - - — - - ■■-■-■■ - - 

well established, that they cannot be passed by without 
some notice of them, as they are explained by some of 
the best writers on the subject. They may be said 
simply to rest on the power of abstracting heat from 
the body, and of stimulating it by the application of 
cold water. The effect is depressing or exciting ac- 
cording as the withdrawal of heat or the stimulation 

First. — Much depends on the form of the bath. 

a. There is its depressing operation ; loss of animal 
heat, retardation of the circulation, and feeling of 
weariness when the same water remains in contact with 
the skin, and there is continued withdrawal of heat 
without fresh stimulation. Under this head come full 
baths, in which the patient remains quiet, partial and 
complete covering of the body with wet sheets left un- 
changed (in which last, owing to an external covering 
being usually applied, the loss of animal heat is less), 
frictions without removing the wet sheets, also local 
baths of a similar nature. 

b. Its exciting operation ; quickening the action of the 
heart and lungs ; feeling of glow and of nervous excite- 
ment; feeling of increased muscular power. These 
sensations occur when the layer of water next the skin 
and heated up by the body is removed, and* fresh cold 
water causes fresh stimulus. Under this head come 
full baths with the water in motion, frictions when the 
wet sheet is removed from the body, douches, shower- 


baths, bathing in rivers or in the sea, and local baths, 
in which the water is changed. 

Secondly. — Much depends on the temperature of the 
water. The feeling of depression occurs much earlier in 
very cold water than in warmer, and, in the same way, 
the exciting operation comes on faster with the colder 
than with the warmer water; but water of the same 
temperature acts differently according to the form of 
the bath. 

Thirdly. — The degree and mode of the operation of 
the bath depends much on its duration. The short 
duration of the bath makes both its depressing and its 
exciting action less ; its longer duration increases them ; 
but if the bath be continued too long, the continued 
abstraction of animal heat may prove very depressing. 

Further modifications of hydropathic practice are to 
be found in the local application of cold, local douches, 
local wrapping up,* and especially in the sitz baths. 
These effects are the greater, because the local ab- 
straction of heat is more powerful than the general, and 

* Like many other modern remedies, the wet sheet has less novelty 
in it than most suppose. Musa, in the reign of Augustus, was one 
of the first professors of hydropathy. He had immense popularity 
until the young Marcellus died in his hands. Lucas, writing a 
hundred years ago, says : " I know a gentleman not far from eighty 
years of age. He sits or stands naked while his servant wraps 
him up in a sheet dipped in cold water, and he continues in this 
from twenty to thirty minutes every morning, winter or summer, 
and in return has uninterrupted health." 


because the action of local can be kept up longer than 
that of general applications. Another important practice, 
though it cannot be in any way considered as being 
peculiar to hydropathy, is the production of copious 
sweating by packing in sheets surrounded by impervious 
covers, by hot air or vapour baths. In this way the 
animal heat becomes so raised that the shock of a cold 
bath can be borne. 

The general effects of hydrotherapy may be thus 
summed up. The system is subjected to alternate 
periods of excitement and of rest. There is a power- 
ful and immediate cooling down of the whole body and 
of its individual parts, especially of the skin, with per- 
sistent contraction of the capillary vessels and local 
anaemia. This is followed by its reverse, or by local 
hyperemia. There is powerful excitement of the vas- 
cular and nervous systems. 

The processes of absorption and of excretion are 
stimulated. The circulation of the blood, and the 
transformation of tissue, must be materially affected by 
the increased amount of perspiration and of water 
introduced into the system by drinking. In most cases 
there is a greatly quickened disintegration and renewal 
of tissue; and in some cases, by the application of 
the milder form of hydropathic practice, they may even 
be retarded. 

In what has just been said, most has been attributed 
to the action of water on the surface of the body; in 


Germany, at least, water-drinking is but a secondary 
part of the treatment, and, indeed, is not peculiar to 
hydropathy; nor has anything been said of the rashes 
and boils which follow the continued application of all 
waters to the skin, and which patients are pleased to 
watch for, under the old notion of their being critical. 

We must next consider warm baths in contrast to cold 
ones. Their general effects may be gathered from the 
following account of their operation at various tempe- 

Warm baths are usually divided as follows, accord- 
ing to their temperature; different people are more or 
less easily affected, just as their sensibility to pain is 
various ; but the average operation of baths is well 

Tepid, 85 to 95 . The effects of a bath of this 
temperature are confined to the peripheral extremities 
of the nerves, and are so slight that they do not extend 
to the central nervous system, or to the circulation. 
Neither the 'pulse nor the secretions or excretions are 
affected. As no heat is taken from the system or 
confined in it, there is no reaction, and the animal 
temperature remains the same. These are the sort of 
baths that people can bear for hours with impunity. 

Warm bath, from 96 to 104 . In this, the action of 
the heat on the peripheral surface is propagated to the 
central circulating and nervous systems, and causes a 
reaction, which manifests itself in a moderately in- 


■1 ■ - 1 1 1 1" -• • 1 im 1 ^1¥¥TTT«-^M1IMflll[IM 1 1—1^1 —II ' 

creased flow of the circulating fluids towards the surface, 
and in an increased frequency of pulse, without affecting 
the respiration. Its further operations are believed to 
be a slight excitement of the process of the renewal of 
tissue, and some operation on the mucous membrane of 
the respiratory and alimentary tracts without materially 
affecting the action of the kidneys or of the intestinal 

With a Hot bath, the temperature of which may be 
taken in different individuals at from 102 up to no° or 
112 , the central nervous and circulating systems are 
more affected. The frequency of the pulse increases 
greatly;* the respiration becomes anxious, quickened, 
and interrupted by deep inspirations. The skin is in a 
hyperaemic condition, and the retained animal heat 
bursts out in a profuse perspiration. 

Very hot bath; everything above no° is very hot, 
and 120 is almost scalding. Such a bath can only be 
borne for a few minutes, and must be used with great 
care, owing to the violent stimulus which it communi- 
cates to the peripheral system. There is violent reflex 
action on the heart and on the whole arterial system, 
and the actions mentioned under the last head are all 

* The contrast between the depressing effect of a cold, and the 
exciting one of a hot bath on the pulse, is strikingly shown by the 
graphic delineations of the sphygmograph. The pulse produced by 
a hot bath is very similar to that produced by active exercise, such 
as rowing. 



exaggerated ; it is only to be used when a very powerful 
stimulus is required. 

Of the above the tepid and the warm bath have an 
especially soothing effect on the system. 

Vapour Baths. — A word or two must be said about a 
modification of the warm baths, in which water is pre- 
sented in the form of vapour. In volcanic countries, as 
in Sicily, the Lipari Islands, and Ischia, natural vapour 
baths have long been in use. It is a familiar fact that 
a man can bear a much higher temperature of vapour 
than of water. The following often quoted table is a 
calculation of the comparative amount of power of 
communicating heat to the body, of water and of vapour, 
the last distinguished as breathed or not ; a distinction 
of importance in various respects : — 




Not breathed. 

Tepid Bath . 
Warm „ 
Hot „ 

85°- 92° 

9 2°_ 98 

98 — 106° 

96 — 106° 

I06°— 120° 

120 — 160° 

90° — IOO° 
IOO° — I IO° 

110 — 130° 

Vapour baths produce profuse perspiration and act 
in cleansing the skin much as hot- water baths. Vapour 
being a slow conductor of heat does not act so fast as 
water on the body. Vapour baths can be borne hotter 
than warm-water ones, but their use cannot be con- 
tinued so long, as vapour being a bad conductor prevents 


radiation from the body. These baths, favourites in 
ancient Rome, and known to us as Russian and as 
Turkish baths, have of late years, the latter especially, 
obtained immense popularity in many European cities.* 
In the use of such baths the detergent action on the 
skin is aided by various mechanical processes, such as 
the application of lather and scraping. In the Russian 
bath a slight amount of stimulation of the surface 
is caused by beating with birchen twigs; but com- 
plete revulsion is produced after the beating process, 
by plunging into a cold bath, or, as in Russia, into 
the snow, or being subjected to a cold douche, after 
which the patient is made to lie down, and remain 
covered up for some time before he quits the bath. 
The great virtue of such baths is mainly in their 
sweat-producing properties, which they share in common 
with various hydropathic processes — than which, however, 
they are pleasanter to the sensations. In this country 
there is great risk of catching cold after vapour or 
hot-air baths. Quite recently I have seen a case of 
haematuria produced by it. 

Vapour baths and douches may be used locally. 

* These baths were common in England three centuries ago. 
Their Eastern name is left behind them in the " Hummums " of 
Covent Garden. They were originally called hot-houses. The 
ladies of the day seem especially to have indulged in them ; they 
were first places where they met for gossip ; then came assigna- 
tions ; and they grew so disreputable under the name of "bagnios " 
that they fell into disuse. Hot air is now more used than vapour. 


It is to be regretted that of the absolute effect of 
simple cold or warm baths on the secreting processes 
very little has been ascertained. Cold baths tend to 
check cutaneous transpiration, warm ones favour it. 

It is supposed that cold baths, by the stimulus they 
give, increase the secretion of the gastric and other 
fluids of the stomach and alimentary canal ; that warm 
baths rather serve to retard it. Either hot or cold baths, 
but especially the latter, serve to favour the secretion 
of urine; and experiments would seem to show that 
warm baths increase the secretion of urea. Whether 
warm or cold baths, like the breathing of hot or cold 
air, have any effect on the exhalation of carbonic acid, 
has not been determined by experiment. 

This r'esumk of the effects of cold and hot baths 
ought to have prepared us for the comparison of their 
operation; in many respects the end obtained by 
the use of either is the same, although the process is 

The warm bath causes swelling and congestion of 
the capillaries of the surface ; then, when the stimulus 
of heat is withdrawn, their contraction ensues. A cold 
bath again first causes a contraction of the capillaries of 
the surface, which is followed by their expansion when 
reaction sets in. Both by bringing a supply of heat to 
the body, and by preventing radiation of heat from it, 
a warm bath increases its temperature ; it can be borne 
longer than a cold bath, and, instead of favouring 


™" ** "' ■ — — ^^* ■ ■ — ■ ■ ■»■■■. ^ _■■ ■ ■ ■ ■ , ■ . IM ■■ ■■ .. ■■■■-■ 1 1 1 M —^^ — m m I 

internal congestions, it draws the blood to the surface. 
There is in either case increased oxidation or waste of 
tissues; but with the hot bath there is no great call 
made on the system to produce the oxidation, which is 
mainly dependent on the increased heat of the blood 
mechanically produced. A theory of why, if a man is 
much exhausted, he feels a hot bath refreshing, while he 
cannot bear a cold one, is this, that the increased heat 
conveyed to him helps the process of oxidation, and so 
relieves his system ; cold refreshes by exciting the func- 
tions — heat by physically relieving them ; a hot bath 
calms by reducing the natural amount of loss of heat, 
and by supplying an equable temperature. 

Very hot baths, it is true, act as stimulants to the 
heart and nervous centres, but they do it more gradually 
and with less shock than cold ones ; and in the main, 
as already said, they occasion a flow of blood to the 
surface, not to the deep-seated organs. Finally, every 
one is familiar with the fact, that warm water softens 
and cleans the skin more readily than cold; and 
sweating may be produced in the' patient by rolling 
him up after a hot bath, just as in the hydropathic 

The general result of this comparison would show, 
that warm baths are a milder remedy than cold ones, 
and applicable often when there is not sufficient power 
of reaction in the system to make it expedient to use 
the latter. 


As we shall have no occasion again to mention the 
effects of simple cold water bathing, this is a convenient 
place to say a few words about some of the applications 
of hydropathy. Hydropathy has suffered from its 
professors having too often undertaken to cure every 
disease by it, by their having practised it in opposition 
to regular medicine ; whereas, when intelligently used, it 
is as much ancillary to it, as any other bath treatment. 
Its importance is greater in England than in most 
European countries, owing to the almost total absence 
of thermal waters of any importance. 

The cold water cure is more useful in functional 
nervous derangements than in any other — hence its 
undoubted value in hysteria, and in many of the com- 
plaints of women, when there is no organic disease. 
It is sometimes useful in hypochondriasis, but less 
certainly so. It is useful where there is excessive 
liability to catch cold, the result of increased nervous 
sensibility of the skin. It has been much lauded in 
rheumatism and in gout, but thermal waters are usually 
better suited for such cases, especially for the gouty 
condition. No doubt mainly by its sweating processes 
it is useful in lumbago, much less so in sciatica, that 
opprobrium medicince; in paralytic affections, and in all 
loss of power depending on any organic lesion, it is very 
disappointing ; but it may be sometimes used with much 
advantage to remove the effects of sunstroke. It is 
not well suited for cases of enlargement of any of the 


abdominal viscera and chronic affections of the intes- 
tines, although I have known it exceptionally to be suc- 
cessful in chronic diarrhoea ; such cases can be treated 
better in other ways. In these days when, with Hebra 
at their head, sceptics have thrown doubts on the value 
of almost all our remedial agencies in skin diseases, the 
effect of continued immersion in water, and of simple 
water applications, is attracting attention. Lastly, there 
are a vast number of people with whom there is not 
much the matter, who still want change ; and for them, 
the change to the diet usually enjoined, to the social 
intercourse of a large boarding establishment, to plenty 
of exercise in a pleasant part of the country, procures 
advantages similar to those of foreign travel, or greater 
perhaps than those of a hurried visit to a foreign spa. 

The contra-indications to this mode of treatment are 
a very lowered state of system — any general cachexy, 
organic disease, and especially of the pulmonary organs. 
If the power of reaction is not considerable, it should 
not be tried ; it suits better under the age of forty or 
forty-five than above it. The too prolonged use of this 
treatment, to which hydropathic professors so often 
press their patients, is to be avoided. The more intel- 
ligent hydropathists themselves admit that they have 
contributed an unusually large number of patients to 
lunatic asylums. 

A few words must be said respecting modes of 
using baths. Something has been already said of the 


water in a bath being in motion or not, and the effect 
this has on the temperature of the body, and the 
layer of water next it. It is a question whether one 
should remain motionless or not in a bath. On the 
whole, in a warm bath one feels more inclined to rest 
than to movement; indeed, it is often necessary to guard 
against falling asleep. In colder baths one is more 
inclined to move, although motion increases the action 
of the cold water. The duration of a bath varies from a 
quarter of an hour to one hour, or even longer ; but the 
long immersions common formerly, and still practised in 
many parts of Switzerland, are not desirable. Old 
people bear protracted immersion in warm baths better 
than young ones. 

When the water is projected with any force against 
the body, as in a wave of the sea, the mechanical effect 
of the blow causes a shock, or irritation and stimulation, 
which is often useful in nervous affections. In many 
baths, by the introduction of gas and by other contri- 
vances, a sort of imitation wave-baths has been produced: 
very powerful remedies are cold affusion and dipping in 
waves, especially when the water is cold. The former is 
most practised after vapour baths, the latter in sea-bathing. 

But douches have assumed such an important share in 
bath treatment, that a few more words must be devoted 
to them. Thickenings of joints, whether the result of 
rheumatism or of gout, are constantly treated with ad- 
vantage by means of douches, which are, in fact, spouts 


of water of various sizes and temperatures, applied with 
more or less force, for a longer or shorter time, against 
the particular part. The operation of the douche con- 
sists in the stimulation of the skin and parts beneath it, 
leading to quickened circulation of the capillaries of the 
part, which favours the absorption of unhealthy deposits, 
wakes up the slumbering activity of the tissues, and 
helps to remove congestions from the more deeply-seated 
parts. The spot consequently to which the douche is 
applied must not be in a state of irritation or of inflam- 
mation. Care must be taken as to the part of the body 
to which it is applied in nervous and excitable people. 
The douche is not to be used continuously — it may be 
employed for two or three minutes, and then used again 
after a pause of some minutes; but in all this much 
depends on habit, and on the patient getting accustomed 
to it. The alternation of hot and cold douches, which 
has somehow got the name of the Ecossaies, is much 
practised in many baths, and is a very powerful remedy, 
from the strong local action and reaction which it 
causes ; more local douches are used in the forms of 
injections, and may be often applied witfi advantage. 
Ascending douches may be used for the intestinal 
canal or the vagina; but they should be employed 
with care: as it is, they are apt to be resorted to 
much too freely, and they may prove injurious in uterine 
complaints. A variety of douche is that which is 
applied to the eye ; it requires to be handled carefully. 

f 2 


The slow process of drop baths has been followed 
in some cases, when a single drop of water falls, from 
a height of about thirty feet, on the particular part every 
few seconds, while the patient sits in the bath \ the effect 
of cold or hot water in such a case being pretty much 
the same. It causes a considerable shock, and cannot 
be borne for more than a few minutes at a time. 

Finally comes the shower bath, the one with which we 
are most familiar in England, the one most generally 
applicable for constitutional purposes, and one of very 
great value. 

To all these modes, which have been barely enume- 
rated, of acting on the capillary circulation of the 
cutaneous surfaces with water, must be added dry 
rubbing, which is far best practised by bath attendants, 
and the various forms of mulling and kneading the 
muscles, stretching the limbs and cracking the joints, 
which are borrowed from the East, and of which ad- 
vantage may be taken at some of the continental or 
Turkish baths. This local treatment is no mean portion 
of the successful management of old thickenings of joints 
and sprains; but it is only at some baths that they 
understand the practice of it thoroughly. The two 
Aixes, Teplitz, and Wildbad are probably among the 
best in this respect. The pleasant, luxurious mulling 
and kneading of a Turkish bath are not all that is 
required for thickened joints. 

We have seen that, though we cannot compel healthy 



skin to absorb water, unless in very small quantities 
indeed, we can undoubtedly make it excrete water, and 
something with it, or perspiration in more than the 
natural quantity. This process of sudation, or of causing 
increased cutaneous transpiration, is involved in so many 
bath proceedings that it requires to be alluded to. 

Perspiration is commonly described as insensible or 
sensible, according as the water escapes unseen, or is 
observed in the form of moisture on the skin. The 
relation of its two forms to each other has been com- 
pared to that of clouds and rain. 

There is considerable analogy between the functions 
of the kidneys and those of the skin, not only in giving, 
off water from the system, but in excreting urea and 
common salt. The skin and the kidneys sympathise 
with each other. Increased cutaneous transpiration 
diminishes the secretions of the kidneys, and vice versd. 
This is familiarly shown by the effects of change of tem- 
perature on the skin. In cold weather the kidneys do 
more work, in hot weather the skin. When those who 
have resided in tropical countries return to Europe, 
extra work is thrown on the kidneys, owing to the great 
diminution of the cutaneous transpiration in the colder 
country, and it takes some time, months or even years, 
before their organs get accustomed to the change. 

The quantity of perspiration depends on the amount 
of water drunk, on the state of the air, ori the amount 
of exercise taken, and also on the constitution of the 


individual. Taking 30 ozs. of perspiration as the daily 
average, J of an ounce would be urea and other 
peculiar solids, while the amount of them contained 
in the urine is 2 to 3 \ ozs. daily. In 100 parts of 
perspiration there are about 97*5 of water, 1 to 2*5 parts 
of solid matter, consisting of odoriferous matter, and of 
the secretion of the sebaceous follicles, urea, a little 
common salt, and some phosphates. About one-fourth 
of the solid matter is said to be urea; nearly 150 
grains of that substance are, it is believed, excreted 
by the skin daily. 

But a certain amount of respiration is also performed 
by the skin. While the quantity of water usually ex- 
creted by the skin is at least double that given off by 
the lungs, -£$ to ^, as much carbonic acid is given off 
by the skin as by the lungs, and a nearly equal amount 
of oxygen is absorbed ; a minute quantity of nitrogen is 
also taken in by the skin. 

It would thus appear that the skin eliminates water 
and effete matter, and aids in the respiratory process; 
and one use of perspiration is believed to be, to regu- 
late the temperature of the body. 

While the average loss to the system by perspiration 
is considered to be 30 or even 40 ozs. in the twenty-four 
hours, calculations have been made as to the loss in weight 
from violent sudation. It has been calculated that a man 
in a Russian bath loses about half an ounce every minute ; 
and it has been found that a man has lost two pounds in 


forty minutes. The average loss by the use of a Russian 
bath may probably be set down at one-half to three 
pounds. In this way a considerable effect may be pro- 
duced on the blood by the abstraction of a large amount 
of water, but it is made up for almost immediately 
from the fluids that we drink. Some have calculated the 
amount of fluid that may be lost by perspiration at a 
much higher rate. 

It has long been a popular notion, both in and out of 
the profession, that specially noxious as well as effete 
matter is got rid of by the system through the per- 
spiration ; and of late years it has been said that in 
some diseases large quantities of uric acid are excreted 
by the skin. The proof of this, however, is very 
defective. Such exudations have very generally been 
found, on examination, to consist of desquamation of 
epidermic cells. Dr. Garrod, a great authority on 
the subject, has never been able to detect uric acid on 
healthy skin. It is too generally supposed that all 
perspirations in disease are necessarily intended to 
eliminate poisons from the system; but this cannot 
well be alike the case in the sweating of rheumatic 
fever, in a fit of ague, or in the hectic of phthisis. 
"Perspiration is often the accompaniment of changes 
called crises, but not necessarily their cause or their 
effect. While, however, much on this subject is un- 
certain, and while no theory of their production is 
satisfactory,' no one can doubt the prejudicial effects 


of sudden checks to the cutaneous exhalation, even 
if the injurious consequences of suppressing the per- 
spiration in animals had not been experimentally 
proved by applying varnish over their skins; and to 
restore the natural function of the skin, when it is 
believed to be suspended, has always been one of the 
admitted principles of therapeutics. 

I believe that we are not generally aware that men 
who are engaged in mechanical labour, which induces 
copious perspiration, and thus washes off some of the 
secretions from the surface, stand less in need of baths 
than people of sedentary habits. 

Before leaving the subject of the external applications 
of water, a few words may be added on the injurious 
effects of hot and cold baths when used injudiciously, 
although something has been already said of the in- 
dications and the contra-indications for their employ- 
ment. The soporific effect, both of hot and lukewarm 
baths, must not be overlooked; this effect is very- 
constant, and has frequently led to death by drowning 
in the bath. The effects of very hot baths are vomiting, 
swimming in the head, fainting, congestion of the brain, 
and, in some rare cases, apoplexy. In such cases, 
after death there is usually accumulation of blood in the 
right side of the heart, and the whole symptoms seem 
to point to paralysis of the heart's action. It is there- 
fore at once evident how cautious people should be 
in the use of very hot baths who have weak hearts or 


any obstruction to their circulation : fat men, and those 
who are full-blooded, and boys predisposed to epilepsy, 
as well as pregnant women, should avoid them. 

It is interesting to find that the primary morbid 
appearance after death from extreme cold, is also to 
be found in accumulation of blood on the right side of 
the heart. 

Though sleepiness is not likely to follow soon the shock 
of immersion in a very cold bath, still it is among the 
effects of exposure to great cold. The risk in cold 
baths is congestion of the internal organs, as is often 
indicated by the lips getting blue, and even in some 
cases by bleeding from the nose ; extremely cold baths 
are therefore very unsafe for all in whom a tendency 
to any internal congestion is suspected: they are not 
adapted for the old or for the very young, or for women 
at certain periods. They are always dangerous when 
the system is exhausted by fatigue. I have often 
known them bring back an ague. 



As all well cures imply the use of a larger than usual 
quantity of drinking-water, it is impossible to overlook 
the share which the water, apart from its mineral con- 
stituents, has on the system. The average quantity of 
fluid taken in by a healthy man, in various shapes, in 
the twenty-four hours, amounts to about four pints; 
some take less, some a good deal more. 

The important function of water in the economy is 
apparent from such facts as these, that it supplies about 
three-fourths of the whole constituents of the body, and 
that nineteen-twentieths of the circulating fluids are 
water; from twelve to twenty-four pounds of water 
would seem to be poured out daily with the excre- 
tions into the intestinal canal, the greater part of which 
is re-absorbed from it The secretion into the alimen- 
tary canal takes place from the arterial and from the 
venous blood; the re-absorption is effected by the 
lymphatics and the extremities of the vena portae. 
The whole amount of water lost in the perspiration 
and in the urine, and through the lungs, from four 


to five pounds, is not to be compared with the daily 
amount poured into the intestinal canal ; none of the 
excretions contain less than 86 per cent, of water, and 
some of them more than 98. One part of the water 
is excreted through the skin and lungs, and is accom- 
panied by various matters, but by no salts. Sweat, 
urine, and milk, again remove peculiar organic com- 
pounds, and especially a considerable quantity of 
inorganic salts along with water; while the third 
portion of water in the system forms the foundation 
of those secretions, the constituents of which are 
re-absorbed, altered or unaltered, such as saliva, bile, 
pancreatic and gastric juices. 

The rate at which water, which has been just swallowed, 
is absorbed, varies according to the quantity drunk, and 
its temperature ; for the more nearly it approaches the 
temperature of the blood, the more easily is it taken 
up. If the stomach is empty, absorption takes place 
very quickly; but if too large a quantity is drunk at 
once, its absorption is retarded. Water is taken up 
mainly by the stomach. The quantity absorbed by 
other portions of the intestinal canal is much smaller, 
and absorption in them takes place more slowly. The 
greatest portion of the water is taken up by the veins 
of the stomach, and is immediately conveyed to the 
vena porta;, the blood of which, under ordinary 
circumstances, contains more water than other venous 
blood. If too large a quantity of water is drunk, there 


may be a feeling of oppression and of weight. 
Absorption may then take some time, and reach its 
maximum two or three hours after the fluid has been 
taken into the stomach, as its excretion through the 
kidneys appears to take place after about such a 
period. The freer the water is of saline constituents, 
the more readily is it absorbed. The quantity that 
has occasionally been drunk, not including what has 
occurred in cases of diabetes, is astonishingly great 
For instance, about twenty-four pounds daily has been 
reached in some hydropathic establishments, and many 
extraordinary stories are told of the quantity of water 
that has been drunk at various wells. 

The effect of swallowing these large quantities of 
water is somewhat uncertain ; little of the water seems to 
pass through unabsorbed. These large draughts have 
occasionally caused constipation, but more often a 
tendency to diarrhoea. 

It appears to be pretty certain, that the quantity of 
water in the blood varies with the quantity of water taken 
in or given out by the system, but the variation of this 
amount is small and imperfectly ascertained. The 
excretion of water usually begins very soon after it has 
been taken in, and continues for two to four hours. All 
water drunk does not pass through the kidneys. The 
proportion passed by them has been stated at as 
10 to n. The quantity of water excreted depends 
much on the state of the body, and what its wants 


at the time may be. Water drinking makes the 
urine more abundant and relatively thinner. There is 
some difference of opinion as to whether it increases 
the excretion of urea or not On the whole, however, 
it seems to be ascertained, that the more the water 
drunk, the more urea is excreted, and along with this 
there is a diminution in the quantity of uric acid. As 
to inorganic constituents of the urine, chloride of 
sodium, phosphoric and sulphuric acids appear to be 
increased, for a time, by drinking large quantities of 
water, and then to be diminished in amount. 

The effect of water-drinking on the excretion of 
carbonic acid by the lungs has not been determined. 
It usually increases the insensible transpiration, but this 
depends a good deal on the external temperature. 
Much water-drinking very markedly increases perspi- 
ration, especially when it is aided by high temperature 
of the water or of the air, by the heat of bed, or by 
active exercise. According to Moslems experiments, 
the excretion of solids through the kidneys was greater 
after drinking water gradually, than after drinking it 
rapidly. The interstitial change of tissue was favoured 
by high external temperature, and by exercise, and the 
use of equal quantities of warm was more effective 
than that of cold water. 

To conclude this abstract of the physiological action 
of water, the water which circulates in the blood is the 
motive power of the nourishment of the secretions 


and of the change of tissue in the part. The secretions 
which are poured into the intestinal canal, and which 
are destined to be again absorbed, are employed in the 
transformation, fluidification, and assimilation of articles 
of food. " The water," says Lehmann, " which is poured 
out with the bile must not be overlooked as a solvent 
for the soluble parts of the chyme; the blood of the 
veins of the liver is much poorer in water than that of 
the vena portae. Water has to make a frequent circuit 
from the stomach into the vena portae, from it through 
the liver and biliary passages, and back into the 
alimentary canal. It thus contributes to the gradual 
fluidification of the chyme, and the more so as this 
water, owing to the bile acids becoming insoluble, 
always loses again in the alimentary canal the substances 
which have been dissolved by the agency of the liver." 
The feet of the increased secretion of bile from 
water-drinking is probably connected with the absorp- 
tion taking place mainly through the stomach and vena 
portae, and we may in this way imagine how it may 
assist the abdominal circulation. 

Again, too small a supply of water must react on 
the animal heat, on the absorption in the alimentary 
canal, and on the secretions, and act generally unfavour- 
ably on the digestion ; while too much water-drinking 
produces a poorness of the blood in soluble salts, unless 
plenty of nourishment is taken. A certain degree of 
water cachexy may thus be induced by an immoderate 


use of water, and one of a more lasting character than 
the so-called well fever. 

Coming now to the therapeutic effects of water, its 
first one is probably, in a great degree, mechanical. It 
expands the stomach and the intestines, the lymph and 
blood-vessels, the biliary passages, the bladder, and 
it may be conjectured that this expansion helps to 
relieve the congestion of the liver, or other viscera ; also 
that it may aid materially the passage of gall-stones; 
in the same way, after free drinking of water, gravel 
may be more easily passed from the bladder. Water 
dilutes the contents of the alimentary canal, and is so 
far laxative. It dilutes them mechanically ; and it also 
serves to dilute the contents of the lymphatics and of 
the veins ; it facilitates the capillary circulation, and may 
thus be supposed to relieve the heart and congestions 
generally; it also dilutes the bile and the urine. 
Further, by its solvent power, it materially assists diges- 
tion. It is quite possible that the solvent power of 
water may even extend to some unhealthy albuminous 
deposits. Water, by making the secretions more abun- 
dant, makes them bring more matter into circulation, 
and removes more decayed cells and effete matter : it 
thus quickens the change of tissue. As the appetite is 
generally improved, there is an inclination to take more 
food, and thus there is increased activity and a certain 
renewal of the system. 

On such principles we can suppose that in some diseases, 


as gout, and perhaps rheumatism, large quantities of 
water are useful in washing out lithic acid. Cadet de 
Vaux's cure of gout, founded on the effects he had seen 
produced by drinking the waters of Plombieres, is well 
known. He directed forty-eight glasses, of 6 to 8 
ozs. of water, of the temperature of 50 to 6o°, to be 
taken successively, one glass every quarter of an hour. 
Water drinking has been especially in repute in chronic 
metallic poisoning; it is easy to see, as the liver is 
the great seat of most metallic poisoning of the 
system, how the free use of water may facilitate the 
elimination of metallic salts, by increasing the amount 
of the secretions, especially of the liver, and aid 
also by its action on the kidneys and skin. Its use in 
the elimination of mercury naturally led to its being 
also employed in syphilis, but it has not been employed 
in it with any particular advantage. 

The operation of hot and of cold water is somewhat 
different It seems probable, that the one has to be 
lowered, and the other to be raised to about blood heat 
before it is absorbed. Probably cooling down takes place 
more easily than heating up; but experience shows that 
overfilling the stomach with water, whether hot or cold, 
retards its absorption. Cold water acts first as a stimu- 
lant, then exhausts the irritability of the stomach, without, 
however, removing its causes. Warm water is a stimu- 
lant, though a less strong one, and also diminishes 
irritability, and reaction is less likely to ensue after it 


Cold water is extremely useful in atony of the stomach ; 
in its coldest form it deadens its irritability, as in the 
shape of ice in obstinate vomiting. In small quantities, 
it acts as a stimulant to digestion ; while if the quantity 
is considerable, it impedes that function. The swallowing 
of cold water to any considerable amount retards the 
circulation. It has been observed to bring down the 
pulse from eighty to sixty-two beats. A tumbler of cold 
water, the first thing in the morning, is an excellent 
stimulant of regular intestinal action. 

Warm water, again, is very useful in painful affections 
of the stomach and of the lower portion of the abdo- 
men; it quickens the circulation, when that is wanted, 
or when perspiration or any bleeding has to be encou- 
raged; it is preferable to cold, when it is desirable to 
make the contents or the secretions of the alimentary 
canal more fluid, and possibly when there is a hope of 
producing the absorption of unorganized deposits. 

Dr. G. Keith, of Edinburgh, has had much practical 
experience of the use of hot water, and has found it 
very useful in many gastric and so-called bilious 
attacks, also in catarrh of the stomach. In chronic 
cases he has found it most useful in exciting the 
action of the liver; a tumbler night and morning he 
finds certainly more efficacious than most cholagogue 

Griesinger, whose recent death medical science de- 
plores, found small draughts of hot water useful in 



bronchial and in laryngeal catarrhs ; and it is quite an 
open question whether the benefit derived in such cases 
from weak alkaline and sulphur springs, does not result 
simply from the drinking of warm water. 

Cold water is generally indicated when the temperature 
of the body is unnaturally high, and may be administered 
freely in most febrile complaints; cold, and for that 
matter, hot water has been, like almost every other sub- 
stance of the Materia Medica, proclaimed a cure for 
intermittent fever. 

If the powers are too low, and in anaemic conditions 
generally, it is not wise to administer cold water 
systematically, and it is a familiar fact that, when the 
system is exhausted by exercise, a warm drink is more 
refreshing than a cold one. 

Certain constitutional effects produced by the use 
of water may be here conveniently noticed. 

Until very recently, much importance was attached in 
all bath treatment to the production of a certain febrile 
condition and certain rashes or eruptions, which were 
looked on as proofs both of the system being saturated, 
and of the occurrence of a crisis. These effects 
appear to be produced as readily by common as by 
mineral waters. For convenience , sake I shall quote 
the effects of Buxton and of Gastein, both of them 
purer than ordinary drinking water. It has been said of 
Buxton, that its waters, though not drunk to a larger 
amount than 4J pints daily, have sometimes affected 


the head with a sort of inebriating giddiness and sense 
of fulness and drowsiness, on first drinking them. 
The following are some of the symptoms recorded 
at Gastein: — Painful feeling of drawing in the limbs, 
excitement of the pulse, sleeplessness, seeing sparks 
of light before the eyes, alternate shivering and heat, 
or something like an ague fit— one or two hours' feeling 
of cold, followed by heat and sweating. This con- 
dition is often associated with pretty sharp diarrhoea 
and rashes, called Badfriesel or la pousste. But much 
disturbance of the system is in no way necessary to 
cure. Braun has written so sensibly on the subject, 
that I transcribe his remarks : 

" From misuse as to quantity and temperature of the 
water drunk (and he might have added from too long 
continued and generally from too hot baths), there often 
arise various shades of discomfort, which vary in 
different individuals, and have most inconsistently been 
called well fever. But just as there is no nymph of the 
well, so is there no fever of it ; and what is understood 
by that term, are conditions induced by over-doing the 
process of cure, often connected with diet and change 
of mode of life, but attended by no certain and constant 
symptoms. The flooding the stomach with water very 
easily excites dyspepsia and gastric catarrh; and the 
peculiarities of mineral waters, such as their heat or 
coldness, the presence of various salts and gases, 
combine to modify this influence. The digestion fails, 

G 2 


nutrition is impeded, the skin is attacked by different 
eruptions, especially by small boils, and sometimes the 
symptoms of the original disease become aggravated in 
sympathy. The violent sweat-producing processes, 
whether hydropathic or otherwise, are particularly apt 
to bring out rashes." 

These feverish symptoms and eruptions, though often 
considered by the patient to be highly desirable, are 
by no means to be wished for. They interrupt the 
course of cure for a time. The treatment may have to 
be stopped for a day or two, but it is soon possible 
to go back again to the well, drinking it in smaller 
quantities, or to the baths, probably using them of a 
lower temperature, and staying in them for a shorter 

It is presumed that water will not be drunk to excess 
by patients under regular treatment; but there is no 
doubt, that inordinate drinking of it may prove positively 
injurious. Large quantities of common hot water and 
of mineral ones have at times caused convulsions, 
delirium, stupor, and death. But much more frequent 
and familiar to all, are the dangers of drinking large 
quantities of cold water, especially when the body is 
exhausted by previous exercise. Instances of sudden 
death from this are known to most people. When the 
death is instant, there is often sudden pain in the head, 
fainting, and apoplexy. The familiar instance of pain 
in the forehead experienced by some people, immediately 


on swallowing ice, has some points of analogy with 
these sudden seizures. Or there may be difficulty and 
spasm of breathing and haemoptysis preceding the fatal 
result. When death is not so sudden, there may be 
violent pain in the stomach, vomiting, or purging; or 
peritonitis or pleuritis may occur. 

With reference to some of the general results of 
water-drinking, the observation of Bernard Gordon, a 
professor at Montpellier, made some centuries ago, 
may be worth quoting : " He who drinks too much 
cold water will not escape disturbance of the mental 
functions and premature old age." What will our 
modern water-drinkers say to this? 



Hitherto we have talked of water as if it were 
chemically pure, but even the best drinking water 
contains a certain minute quantity of mineral salts, or of 
organic impurities. Indeed, water not perfectly pure 
is pleasanter to the taste than distilled water, and it 
always tastes mawkish, in the absence of some atmo- 
spheric air, and of some slight amount of salts. 

There are some wells which supply a water too much 
impregnated with mineral matters, to make it fit for 
common use, but which is still found to be useful in 
the treatment of disease. There are also springs, the 
heat of which exceeds the average temperature of other 
wells in the same place. Such waters are called mineral 
ones ; and these definitions, though open to objections, 
will answer for practical purposes. It is generally 
considered, that waters with more than five grains in 
the pint of solid matter, should be counted mineral, 
but no such proportion can be arbitrarily fixed, for 
there are good drinking waters that contain nearly 
as much, and some of the indifferent mineral waters 
that contain much less. 


The number of elementary substances, that have 
been found either free, or usually in combination in 
mineral sources, is very large, as appears from the 
following list The most minute portions of these 
substances are now detected by spectral analysis : — 

Oxygen and ozone, nitrogen, chlorine, hydrogen, 
carburetted hydrogen, carbonic acid, ammonia; hydro- 
sulphuric, hydrochloric, sulphuric, sulphurous, nitric, 
nitrous, phosphoric, antimonic, silicic, and boracic acids ; 
calcium, sodium, potassium, bromine, iodine, arsenic, 
sulphur, lithium, rubidium, caesium, barium, strontium, 
magnesium, aluminium, manganesium, fluorine, iron, 
copper, lead, zinc. 

The Materia Medica list of the constituents of mineral 
waters is thus very long, and it would be no easy task 
to appreciate the influence of each of these substances, 
if it were necessary to do so; but although bath 
doctors have with pride boasted of the number of 
substances entering into the composition of their 
waters, and have held this out as a recommendation, 
the active principles of mineral waters are compara- 
tively few; they exist in very varying quantities, 
sometimes scantily, sometimes abundantly, while the 
other constituents are commonly found in mere traces ; 
and it is very doubtful whether such minute quantities 
modify the action of the waters — if they do, it is in 
a way quite beyond our ken. 

The really important constituents are, carbonate and 


sulphate of soda, chloride of sodium, carbonate and 
sulphate of magnesia, carbonate of lime and carbonate 
of iron and their sulphates, bromine and iodine, car- 
bonic acid, hydro-sulphuric acid and nitrogen. 

It may be borne in mind, that we cannot be said 
to know very accurately, the real chemical constitution 
of any but the simpler mineral waters. The chemist 
finds by his analysis bases and acids, but he cannot 
tell us with absolute certainty, how they are combined. 
In fact, the chemical composition assigned by the 
analyst to a particular water, often depends on his 
theoretical views on chemistry. Although some slight 
differences of composition have been detected in springs 
at different seasons of the year, yet it is extraordinary 
how long their character has remained unchanged; in 
many instances, certainly since the commencement of 
the Christian era. 

But besides having mineral constituents, many waters, 
especially thermal ones, deposit large quantities of a 
glairy substance, which has received the names of 
baregine, glairine, and of zoogene. This substance, 
though of no importance in medicine, unless perhaps 
when bemg present in large quantities it gives softness 
to the water, is essentially organic, and is interesting to 
us at this time, when protoplasm, to which it bears 
some analogy, is the subject of so much discussion. 

Baregine, to the naked eye, is a jelly-like substance, 
in which some filaments are apparent. On micro- 


scopic examination it has been resolved into two parts, 
one amorphous and unorganized, usually colourless, and 
when calcined giving an odour of ammonia, and leaving 
a little ash of silica. The other is found to be made 
up of low organic forms, differing in different wells; 
the diatomaceae being abundant in some, in others con- 
fervaceae, forms resembling oscillatoriaceae, nostochineae, 
also anabaenas, some of these oscillatoriae forming very 
beautiful and regular net-like figures on stones which 
they envelope. Some writers are of opinion that the 
first or jelly-like substance, out of which these oscillatoriae 
grow, may be resolved into agglomerations of hydrocrocis 
and leptothrix. However this may be, the production 
of this glairy substance in mineral waters is a very 
curious phenomenon, not satisfactorily explained. It is 
believed that it is formed at great depths, and that it is 
only after it has been exposed to the air, that those low 
forms of vegetation appear. They seem to bear a certain 
proportion to the temperature of the springs, and in 
some cases to the amount of sulphur present But 
this interesting subject, as it has no bearing on the 
curative effects of water, cannot be pursued further 

The mineral waters that first arrested the attention 
of men, and which in early times were usually dedi- 
cated to various divinities, and in more modern ones 
to different saints, were those which differed most 
palpably from ordinary water, and those were warm 


or thermal springs, and sulphur ones. The heat in 
one case, and the smell in the other, attracted notice. 
Mineral waters occur in almost every portion of the 
world, but we are mainly concerned with those of 

It is of thermal and other springs in Italy and 
Greece that we have the earliest accounts. Herodotus, 
for instance, notices the fountains of the Tearos in 
Thrace ; some were hot and some cold, and they cured 
skin complaints of men and of animals. Some of the 
waters of Ischia are probably as hot as those of 
Kamschatka and of Bishisht in India, probably the 
hottest in the world, reaching nearly to 212 . Thermal 
springs are almost absent from Great Britain and 
Ireland, Denmark and Belgium; tolerably abundant 
in Germany and Switzerland, much more so in France, 
Spain, Portugal, and in Italy. Thermal springs vary 
much in the quantity of water they supply; probably 
of entirely natural sources, the Sprudel at Carlsbad and 
the well at Dax in the Landes yield the greatest supply. 
That of the latter was calculated at a ton and a half of 
water per minute. Thermal springs occur at every 
height from the level of the sea, or nearly so, in Ischia 
and Iceland, up to 12,000 feet in the Cordilleras, and 
16,000 feet (from beneath a glacier) in the Himalayas. 

The number of sulphur wells in all parts of the 
world is great; the largest group in Europe, by far, 
is the Pyrenean one, especially if we include those 


on the Spanish as well as on the French side of the 
chain ; and if we were to include every spring which 
gives forth a slight odour of sulphuretted hydrogen, 
the number might be indefinitely increased. 

The other kinds of mineral water which were early 
noticed for their; sparkling bubbles, their yellow 
deposits,* their salt or bitter taste, need not be dilated 
on here. 

Springs of mineral water arise tinder all circumstances, 
in open plains and in broken country, but undoubtedly 
they prefer the latter. They, and particularly thermal 
springs, seem to be most common in volcanic districts, 

* It is not for want of steady efforts to bring such waters into notice 
that the use of many feeble springs has been abandoned. Dr. Monro, 
in 1770, enumerates in London and its immediate vicinity, Dulwich, 
Streatham, "Dog and Duck" in Lambeth, Sydenham, Bagnigge, 
Acton, Epsom, Kennington, Richmond, Shadwell, Hampstead, 
Islington, Pancras ; and there were also Beulah Spa and Kilburn. 
Who hears of these wells now ? Dr. Rutty also, in the last cen- 
tury, introduced to notice nearly sixty springs in Ireland, now all 
but forgotten. In Scotland, too, many springs were recommended, 
but after a time abandoned. I may instance the Gilcomston Spa, 
in Aberdeen. As long ago as 1580, a broadside was printed on 
"the Well of Woomanhill, beside Aberdeen." In 161 5 appeared 
"Calirrhoc The Nymph of Aberdeen resuscitat by William 
Barclay, Master of Arts and Doctor of Physick ; what diseases may 
be cured by drinking of the well of Aberdene, and what is the 
true use thereof." Later came professors fresh from Leyden, and 
knowing something about foreign spas. They made great attempts 
to bring it into favour, but failed. By the year 1 7 70, a chalybeate 
in that district, at Peterhead, had become a place of resort. 


at points of great displacement of strata, or at the 
junction of stratified and unstratified, or of sedimentary 
and crystallized rocks; a great many of them occur 
in narrow, picturesque valleys, such as Plombieres, Ems, 
and Carlsbad, and this picturesqueness adds materially 
to the popularity and to the absolute utility of the 
springs. This in the main, although there are also 
disadvantages connected with such situations. 

Mineral waters may be grouped in a variety of ways, 
for instance, according to the district in which they 
occur ; and in this way the Pyrenean, the Auvergne, the 
Nassau, and the Bohemian ones, would each form natural 

It has again been attempted to connect them with 
geological formations, and the waters of the Pyrenees 
have been subdivided on this principle, and they have 
been classified as they occur in formations of different 
ages. Thus springs of one character were supposed to 
occur in primary rocks, of another in tertiary, and of 
a third in the neighbourhood of extinct or of active 
volcanoes. Even if such a classification could be 
carried out, it would be of no use to us, as theoretical 
notions regarding the origin of a well can never have 
any bearing on its practical use. 

A much more practical division is into cold, and hot 
or thermal ; and thermal springs may be considered to 
be those, the temperature of which is higher than the 
mean temperature of the place where they rise. Of 


the conditions influencing thermality little is known. In 
a general way it is believed to be connected with chemical 
action going on in the rocks which the springs have to 
traverse, and on the depth from which the springs arise, 
as the fact of the central heat of the earth might lead 
us to suppose. The distinction between hot and cold 
waters corresponds very closely with that of water used 
for baths, and of waters used for drinking ; but many 
mineral waters are used for both purposes, so this division 
would not be always applicable. 

It has been most commonly proposed to class waters 
according to their chemical composition; and on the 
whole this division is the most valuable one, as affording 
some clue to their therapeutic action ; but nothing like 
a chemical classification has yet been found, that is not 
open to many objections. The extremely complicated 
composition of many springs stands in the way of satis- 
factory classification. 

But as such classifications are an important aid to 
the knowledge of their properties, and also supply general 
views of their comparative constitution, I give two of 
the more popular French ones : — 

( Sulphuret of Soda. 
Sulphur Waters . . } Sulphuret of Lime. 

I Chloride of Soda. 
Common Salt Waters j Chloride of Soda bicarbonated. 

( Chloride of Soda sulphuretted. 

1 Carbonate of Soda. 
Bicarbonated Waters . < Carbonate of Lime. 

( Mixed Carbonates. 



Sulphated Waters . 

Iron Waters . . 

! Sulphate of Soda. 
Sulphate of Magnesia. 
Sulphate of Lime. 
Mixed Sulphates. 
! Bicarbonate of Iron. 
Sulphate of Iron with Manganese. 


Carbonated . 

Soda base. 
Earthy base . 



Chlorides . 

! Ferruginous. 
STrue Sulphur. 
Degenerated Sulphur. 
i Simple Sulphates. 
. < Mixed Sulphates and 
( Sulphurets. 
Magnesia base , Sulphated. 
Iron base . . Sulphated. 

All a Soda base | Si ^' Iodine . 

Soda base 

Lime base 

The next is a German classification : — 

( i. Simple Carbonated. 

I. Alkaline < 2. Alkaline. 

( 3. Alkali and common Salt. 
II. Glauber Salt 

/ 1. Pure. 

III. Iron < 2. Alkaline and Saline. 

( 3, Earthy and Saline. 
t 1, Simple. 

IV. Common Salt . . . . < 2. Concentrated. 

( 3. With Bromine or Iodine. 
V. Epsom Salt 

VI. Sulphur. 

VII. Earthy and Calcareous. 

VIII. Indifferent. 


There are many points in favour of a mixed physio- 
logical and therapeutic classification, although an idea 
once thrown out, that the constituents of mineral waters 
might be discovered by watching their effects on the 
system, carries this notion too far. Thus the digestive 
and urinary organs are specially affected by alkaline 
waters ; the liver and the alimentary canal by saline ones. 
The skin and, according to continental authors, the 
mucous respiratory membrane are much influenced by 
sulphur waters, while a special action on the blood has 
always been attributed to ferruginous sources. 

Still more generally they have been divided accord- 
ing as their action is stimulant or depressing. But the 
same waters may act in either way, according to the 
mode in which they are employed. 

I do not think that the simple empirical use of the 
waters has produced results that would justify us in 
classifying waters according to the diseases they cure, or 
their apparent general effects on the system. Besides, 
it is found that the same source cures the most different 
diseases; and that similar diseases are often cured by 
very different waters. 

The classification here adopted, mainly borrowed from 
Braun, will be a general practical one, founded, 1st. On 
whether the water is used chiefly for bathing or drinking; 
2d. On its predominating chemical constituents, with 
little reference to its less important ones. 

In Germany the great majority of the watering-places 


are public, while in France the great majority are private 
property; but in all cases their general control and 
management are undertaken either by the State or by 
some governing bodies, which appoint both physicians 
and bath inspectors, sometimes with and sometimes with- 
out a salary. At most baths, if you stay more than a few 
days, you are called on to pay a small tax for keeping 
up the establishment or its band. In Spain you cannot 
drink the waters at all, without making a small payment 
first to the doctor of the bath. 

The arrangements for drinking mineral waters are 
different at the various wells and mineral stations. In 
some cases the wells are open and surrounded by light 
railings ; in others they are covered in by pavilions or 
miniature temples. In some places, where the supply is 
not very abundant, and the demand is great, the drinkers 
have to pass in between railings, such as are used at the 
entrance of theatres. 

The pleasantest arrangement is, when the water is 
served out fresh, as it issues from the open well at Hom- 
burg, by active, good-natured girls; another common 
one is, that a rod, with an arrangement for holding half 
a dozen glasses at its end, is dipped down into the well ; 
and the least pleasant or natural way is when it is 
pumped up by a special apparatus. It is now usual, 
and the most convenient arrangement, not to bring your 
own glass, but to take one supplied to you ; it is often 
necessary to pour the water backwards and forwards 


i ■ -1 n 1 1 — ■ 

between two glasses to cool it, and still more to get 
rid of any great excess of carbonic acid. This is an 
operation which is very neatly performed by the nymphs 
of the fountains. The glass usually contains from about 
5 to 8 ozs., but there is no uniformity in this respect 
among the different spas. This is very unfortunate, for 
in appreciating the therapeutic value of waters, an exact 
knowledge of the quantity of a water drunk is very im- 
portant. At many wells the ladies make a point of* 
drinking the waters through a glass tube, to prevent the 
waters injuring their teeth. There is really no risk of 
this, but there can be no harm in using the tube, 
especially if the spring is very cold. In some instances, 
when patients suffer from laryngeal or bronchial affec- 
tions, they are directed to drink their water diluted with 
milk or whey, or gum water. 

The bathing arrangements are usually under the super- 
intendence of a local inspector, from whom tickets for 
baths are procured. You get a set of baths cheaper 
than single ones. There are first and second, and 
often third class baths ; in various places too, indeed 
in most, as in Wildbad, there are baths for the poor. 

Austria and other German States have baths for their 
soldiers ; France no fewer than ten of them : counting 
six in France, one in Corsica, two in Algiers, and one in 
the Island of Bourbon. And here the question naturally 
suggests itself, whether England might not do something 
in this way either at home or abroad. There is no 



question that Bath is quite as efficacious as most of the 
foreign calcareous thermal baths. In India, Government 
has been very active in selecting sanitary stations in the 
mountains, and it encouraged an investigation of the 
mineral waters of India, which I had the honour to 
suggest in 1853. But the inquiry had little result, 
mainly because Indian, like English practitioners, take 
slight interest in the subject. It can scarcely be said, 
in spite of one or two creditable exceptions, that 
any serious attempt has been made to utilize the 
waters of India, though they are much employed by the 

Some of the buildings set apart for bathing in the 
older spas are, as at Plombieres, of great antiquity ; 
although I believe that at no station, unless at Wiesbaden, 
are any actual Roman remains now employed. As a 
general rule, new baths, like new hotels, are pleasanter 
than old ones. Some of the most modern and com- 
plete establishments I have seen, have been at Plom- 
bieres, Aix-la-Chapelle, Wildbad, Aix, Vichy, and the 
new bath at Carlsbad ; but fresh excellent buildings are 
springing up everywhere. 

Baths may be divided into single and common ones ; 
the first are far the most convenient and most employed : 
they are ranged in cabinets usually opening off each 
side of a long corridor or passage ; they are commonly 
metallic tubs, in some instances wooden ones, into which 
you step, or they are depressions in the floor of the 


bath-room, lined with flags, marble, or porcelain, accord- 
ing to the class of the bath, into which you descend. 

These single baths are greatly to be preferred to the 
common baths, or piscinae of every size, which are to 
be found at most spas. In them it is necessary to wear 
a light shirt, and they are often crowded. There is a 
prejudice against them on the score of possibly catching 
contagious diseases in them,* but care is taken to exclude 
those suffering from such affections ; and, as a matter of 
fact, I believe that there is no case on record of any 
one having ever been so affected. The convenience of, 
or rather the necessity for the piscinae, is in stations, as 
Barfeges, where the supply of water is scanty; but if 
they are used at all, there should be a sufficient flow of 
fresh water through them. 

Up to a very late period, common baths for men and 
women were usual ; but this most undesirable practice 
of the two sexes bathing together, has been pretty nearly 
abandoned. It is still kept up at Leuk, where one of the 
sights for visitors is, to see men and women sit in water 
for hours, with drinks and card tables floated to them 
on trays, and, I believe, the practice is still followed at 
Baden in Switzerland, and Baden near Vienna, and at 
Ofen on the Danube. The nearest parallel to this may 
be found in Japan, where men and women bathe pro- 
miscuously without any coverings. 

* In old days, persons coming from infected places to Plombieres 
were liable to capital punishment. 

H 2 


There are many varieties of baths, such as full, half, 
and sitz baths, foot, and other partial ones; others, 
in which a kind of attempt at imitating the waves 
of the sea is made: all ordered according to circum- 
stances by the doctor in charge, who will also give 
directions, as to whether the patient is to remain quiet 
in his bath, or splash about, or whether it is desirable 
that he should exercise himself in swimming, in which 
case one of the larger baths, such as those in Aix in 
Savoy, must of course be used, also how long he is to 
remain in his bath. 

Then there are, in different establishments, various 
forms of drop and of shower baths ; the former chiefly 
used for enlargements of joints. At some places they 
have a complicated revolving case of perforated tubing, 
through which a sort of circular shower is projected 
against every portion of the surface of the body. There 
are douches which vary according to the force with which 
the water is propelled, the size of the bore of the muzzle 
of the pipe, and the temperature of the water. 

In many bath establishments there are chambers for 
the inhalation of the vapour of the waters or their gases ; 
there are also gas baths, and gas douches. 




We have hitherto considered the effects of bathing in 
simple water of various degrees of temperature, and from 
what has been said it will be apparent, that in all bath- 
ing cures, the greatest share in the production of the 
beneficial result is to be attributed simply to the judicious 
application of water. And this is the most rational way 
of accounting for the immense popularity, for centuries, 
of many of the indifferent springs, in which chemistry 
has never detected anything, that one could reasonably 
suppose to act on the system. We have seen, how- 
ever, that there are also more powerful mineral springs, 
variously impregnated with a variety of gases and salts. 
Some of the chief gases are, carbonic acid, hydrosul- 
phuric acid, oxygen, nitrogen ; salts, as chloride of soda, 
.carbonate of soda, carbonate and sulphate of magnesia ; 


in smaller quantities, iron, iodine, and bromine ; in still 
smaller, such substances as barium, caesium, arsenic, 
lithium, strontium, and rubidium. 

Have any of these substances a distinct action on the 
system through the process of absorption by the skin? 
It had long been taken for granted that such sub- 
stances were absorbed. After immersion in the soda 
baths of Vichy, the urine was found to be alkaline ; 
where could you have a clearer proof of the absorption 
of alkalies ? but, unfortunately for this conclusion, it was 
found that baths with scarcely any mineral constituents, 
or with salts that were not alkaline, also produced this 

The general result of experiments appears to show 
that the skin readily absorbs the gases of fluids, their 
mineral constituents very slowly, if at all; but at the 
same time there is no doubt, that the stronger mineral 
waters produce a positively stimulant effect on the skin, 
beyond the action of the mere water. 

Clemens has arrived at the following results : — i. That 
a few gaseous substances, such as hydrosulphuric acid, 
readily penetrate the skin. 2. Other substances pene- 
trate slowly, but they take so much time, that their doing 
so can really be of little importance in balneology ; 
such as iodine and water. 3. Others can only penetrate 
the epidermis, and work solely by their stimulant effect 
on the surface nerves, such as common salt, chloride 
of lime, salts of lithia, corrosive sublimate, salts of lead. 


4. Some substances only penetrate the epidermis in the 
most minute quantities, such as sulphate of iron, iodide 
of potash, sulphate of soda. 

The first class of baths is that of indifferent waters, 
which contain very small amounts of mineral con- 
stituents, and along with these may be counted the 
earthy ones ; for their lime salts, chiefly gypsum, are the 
least of all likely to be absorbed, or to act much on the 
surface. This class of waters acts mainly like simple 
warm baths on the skin. Their first effect, at tem- 
peratures of about 90 to 96 , is to excite gently the 
peripheral nerves, to make the circulation more active, 
render the respiration freer, and produce a desire to 
make water, which effects are followed by increased 
frequency of the pulse, increased cutaneous transpira- 
tion, and augmentation of the urinary secretion. They 
regulate the action of the skin and that of the kidneys, 
and seem to have a power of dispersing exudations. 
They improve the appetite, and they make the ingestion 
of more nourishment possible. A great many patients 
find the effects of even the least mineralised waters to 
be exciting. 

The great majority of indifferent wells are thermal. 
Indeed, where there is no smell of hydrosulphuric acid, 
they would never have attracted attention but for their 
higher temperature. 

As a great many of the more important indifferent 
thermal springs, which used to be called wild baths, 



Aqua FerincBj or TTierma Silvestres, rise at a very con- 
siderable altitude above the sea-level, and many of them 
owe at least an important share of their curative effects 
to a more or less Alpine climate, the following list of 
some of them may be interesting. The heights given 
may not in every case be absolutely accurate ; the 
measurements in feet of different countries have been 
mixed up together, but the general average result is what 
is of importance to us. The temperatures given are 
the natural ones of the springs, not of the baths as they 
are employed. 


I. With scarcely 

Panticosa .... 
Gastein ..... 


Bagneres de Bigorres 
Badenweiler . . . 
Wildbad . . . . 
Plombifcres . . . 
Warmbrunn . . . 
Liebenzell . . . . 
Schlangenbad . . . 
Buxton ..... 
Romerbad . . . . 


Bormio . . 
Leuk . . 
Chianciano . 

any Mineral 


5,800 . 

3.315 • 

2,115 . 

1,850 . 

1,425 • 

1,323 • 

I,3IO . 

I,IOO . 

IOO . 

900 . 

900 . 

750 . 

658 . 

2. Earthy. 

4,400 . 

4,400 . 

3,800 . 

1,800 . 



85° - 95° 
95 —"8 
98 — 100 


69 — 81-5 

HO ' 

86. - 156 

95 —105 

7i*5— 77 
80 — 87 


94 — 98 

95 — 120 





— 104 

— 123 

— 95 


3: Sulphur. 


Escaldas 4*380 

Bareges 4,100 

Cauterets 3»254 

St Sauveur 2,525 

Eaux-Bonnes .... 2,400 

Ax 2,300 

Bagneres de Luchon . . 2,000 

La Porretta 1, 100 

Baden, S 1,100 

Schintznach 1,060 

Aix, S 790 


. . 108 — 1 14° 

. 87—II3 

• 71 —134 

70 — 109 

■ 55-89 


. I02 —I34 




112 — II4 

Indifferent baths, especially the milder ones, are often 
found useful in calming the nervous system; the con- 
tinued use of lukewarm baths is found to have a 
beneficial effect in over- excitability of the nervous 
system, and in tendency to spasms in hysterical women, 
also in painful menstruation, and a large class of 
nervous cases, where there is over-excitability of the 
spinal system. 

They find a further application, when hyperesthesia 
manifests itself in the form of neuralgia, especially in 
those forms which have a gouty or rheumatic foundation, 
and in those which are the consequence of former 
injuries, and of exudations consequent on them, or of 
inflammation of the nervous sheaths. The prognosis 
is less favourable, when there has been any wasting of 
the part, or there is incipient paralysis of it Some of the 
neuralgias that receive most benefit, are face, brachial, 


intercostal ones, local affections of portions of skin, par- 
ticularly the result of exposure to cold, and sometimes 
neuralgia of the breasts. True tic again is. very seldom 
cured, and sciatica usually resists all thermal treatment. 

Loss of power in its various degrees is treated often 
with much success, by the use of the warmer baths, 
which probably operate by reflex action on the motor 
nerves; but if electro-muscular contractility is found 
to be quite gone, little can be expected from them. 
It is therefore always wise to ascertain beforehand, 
experimentally, by electricity, the real state of the mus- 
cular contractility, and it may be remarked, that elec- 
tricity, used in connexion with baths, assists their 
efficacy much; practical men seem to think that the 
use of electricity, before and after a course of bathing, 
is of more use than when both agents are used simul- 

The cases which gain most from thermal treatment, 
are those in which the exciting cause of the paralysis 
is removed, while the loss of power continues ; such 
are partial paralysis after diphtheria, and some effects 
of typhus; also loss of power of the lower extremi- 
ties, the consequence of bad confinements, and paralysis 
from lead-poisoning; in such cases, in many of which 
recovery would, in the natural course of things, ensue 
in time, recovery is often greatly accelerated by the 
exciting action of the hot waters. The results of 
shocks or blows, or of violent impressions on the 


nervous system, are often removed; but where any 
mechanical cause exists for the paralysis, benefit cannot 
be expected. In all these cases, the judicious appli- 
cation of douches has much to say to the cure. Care 
must always be taken never to use water hot enough to 
produce blistering in paralysed limbs. 

In certain cases of more serious paralysis — the results 
of apoplexy, or of the effusion of blood in the brain 
— thermal treatment may be of considerable advantage, 
especially if the cases are not treated too soon after 
the apoplectic attack; but much caution is always 
required in such cases, and the state of the heart and 
blood-vessels must be carefully ascertained. 

In cases of hemiplegia, in which the brain has under- 
gone structural alterations, and in paralysis agitans, or 
progressive muscular atrophy, little is to be expected. 

In paralysis of spinal origin a good deal may be 
hoped for, if there be any rheumatism present, especially 
if the case is hot too old, and if the power of the 
sphincters has not been lost. In true tabes dorsalis no 
benefit is obtained, and it is miserable to see such cases 
dragged from one spa to another, in the vain hope of 

Gout is not cured by any waters, but is often alleviated 
by them; the earlier gouty patients resort to them, 
the more likely are they to derive benefit from them. 
But it is especially in the results of gouty deposits in 
the joints and synovial membranes, and the skin and 


surrounding cellular tissue ending in stiffness, that the 
steady application of these waters is most useful, and 
in such cases there often takes place such an amount 
of absorption of previous exudations, that one or two 
seasons at a bath may give relief for a series of years. 
It is the cases of gout in weak and flabby and older 
patients, that are most suitable for these cures. 

Chronic rheumatism profits much by thermal treat- 
ment, whether it has all along had a chronic character, 
or is the result of an acute attack, especially when 
there is much thickening of the joints or old muscular 
rheumatism. Of course it is very necessary to be sure 
that you do not treat by the hotter baths, cases com- 
plicated with heart disease. Simple effusion into the 
joints, pseudo-anchylosis, adhesions of the sinews to 
joints, exudatory bands in the cellular tissue round 
joints, often find resolution, if the limb has not been 
too long kept in one position ; but no cases where 
absolute destruction or absorption of surfaces has taken 
place, can expect benefit, and scrofulous .cases gene- 
rally derive no advantage. 

Thermal waters are useful in cases of old ulcers and 
wounds, and in metallic poisoning ; but these affections 
will be noticed under the head of sulphurous waters, 
which have the reputation of being still more efficacious. 

In affections of the joints the waters must be used 
very warm, and the treatment is most materially 
assisted by local douches and frictions. The bath 


~ — ■■ 1 1 ■ - ■ — - - ■ — ■■■■■■■__. - 

treatment of joints very often produces exacerbation 
of the feelings of discomfort in them, in the first 

The following are the chief indifferent baths; their 
mineral constituents are so trifling in amount, that they 
do not deserve separate mention. 

Gastrin is in many respects the chief of indifferent 
thermal baths, whether we consider its altitude, the 
magnificent scenery in which it lies, or its ancient 
repute — for it is one of the oldest baths in Europe. The 
districts of the Saltzkammergut and parts of Styria 
have of late attained that popularity with the English 
which they deserve, and Gastein is now more visited by 
them. It is, however, still twelve or thirteen hours' drive 
from Saltzburg, the nearest railway point, and will always, 
owing to its remote position, probably continue to be 
one of the most select watering-places. 

It combines the advantages of an Alpine climate, 
of sufficient elevation, and of. excellent bath arrange- 
ments. The chief drawback in ft, as in most mountain 
stations, is the heavy fall of rain ; in June and July the 
rainfall is twenty-one to twenty-two inches. The mean 
temperature of June, July, and August varies from 54 
to 59 . The season is unfortunately short, owing to 
the coldness of the climate; and the best season is 
from the middle or end of July, up to the first or 
second week of September. The temperature at which 
the baths are used varies from 86° to 104 ; some 


patients can only bear them for ten minutes, others 
remain in them for an hour. As the lodging accom- 
modation is scanty at Gastein, many visitors are 
accommodated at Hof Gastrin, 500 or 600 feet lower, 
whither the water is conducted from Gastein, and is of 
the temperature of 95 . There are no shady walks 
here as at Gastein, but the most interesting excursions 
can be made from both. Besides producing the usual 
effects of other indifferent thermal waters, Gastein is 
found to be particularly useful for persons of advanced 
years, for some forms of hysteria and of hypochondriasis, 
for calming the nervous system and allaying cerebral 
irritability, perhaps also in the effects of sunstroke. It 
has a special repute in cases of tabes dorsalis and 
of impotence. But the basis of the reputation of any 
waters in such cases is always very doubtful. 

Romerbad or Tuffer, in Lower Styria, deserves to 
be mentioned, owing to its having a fine climate, and 
being a place of resort easily reached from Vienna or 
Trieste. The temperature of the baths varies from 94 
to 98 . It lies 750 feet above the sea, and it fulfils 
the indications of the milder thermal baths ; according 
to analogy, its effects ought to resemble those of 
Schlangenbad. The place is prettily situated, much 
visited by the Trieste people, and might be convenient 
for English families settled in Gratz. 

Pfejfers and Ragatz, — Similar in their effects to Gas- 
tein, are the baths of Pfeffers, 2,130 feet above the sea, 


in the valley of the Rhine. They are elevated enough 
to give something of an Alpine climate, but they are 
situated in such a gloomy though extraordinary ravine, 
eroded by water, in limestone rock, that no invalids 
would from choice reside there, especially as the 
waters are conveyed to Ragatz, about 500 feet lower, 
where the comforts of hotels and new baths are to be 
had in an open smiling valley, with fine Alpine scenery 
around. The climate is, on the whole, a mild one; 
the extremes are less than might have been expected. 
The place is very accessible, being on the railway to 
Chur, and on the way to St. Moritz; it is also one 
of the nearest points to Davos, which has of late been 
brought forward as a climatic resort for chest complaints: 
in winter a very doubtful experiment Ragatz is suited 
for much the same class of cases as Wildbad or 
Gastein, and is not expensive. They drink the water 
at Pfeffers, and also bathe in water of an average 
temperature of 98 . 

In former days Pfeffers had an immense name, and 
Paracelsus wrote full accounts of its virtues in a great 
variety of diseases.* It has now no longer any repute 
in the treatment of skin diseases, nor indeed is any 
special class of diseases the subject of particular treat- 
ment On the whole, it seems best adapted for nervous 

* Contraction of limbs, paralysis, gout, and rheumatism, old 
fevers, calculus and gravel, skin diseases, and some complaints of 


affections of women and some irregularities of their 

There are vapour baths and douches, and no doubt 
many cases of gout and rheumatism might be treated 
here, though the treatment is not energetic enough for 
thickened joints. 

Wildbady in the Black Forest, at a height of 1,333 
feet, with a pleasant climate in the summer months, 
can now be reached the whole way by railroad, and 
in twenty-four to thirty hours from London by Paris and 
Strasburg. The temperature of the baths varies from 
8 9 to 97 . Wildbad has new baths, both common and 
single, which are being extended, and excellent hotels 
and pensions : the living is moderate. The scenery of 
the Black Forest is sub-Alpine and very pleasing; in 
short, there is everything here to make a bath liked by 
those who can exist without the presence of a gambling- 
house or of other strong excitement 

It is perhaps more destitute than any other place of 
the kind, of an apology for a drinking well; such as 
it was, are most vapid. There are baths here for 
the poor as well as the rich — single baths, and others 
to be used by more than one. The bottom of the 
baths is covered with a very fine sand. Although the 
baths are shallow, the supply of water is ample, and 
it is in a state of constant renewal ; and on the whole 
there is no place that should suit patients better, in 
search of such effects as can be looked for from thermal 


waters. All the arrangements about the baths are 
excellent. Though adapted for the milder treatment 
of gout, Wildbad appears to be chiefly resorted to 
for various forms of paralysis. I observed more lame 
and paralysed patients here than anywhere, except at 
Teplitz. A peculiar breed of dogs of the country, 
which appears to be " gone v in the forelegs, cuts an 
amusing figure among the lame human beings. 

Wildbad has almost everything that can recommend 
a place to the English. But of late years the resort 
to it has been inconveniently great, and it may be well 
supplemented by two less known places, which are men- 
tioned next 

Liebenzell, 995 feet high, a small quiet spot within 
about eight miles of Wildbad, possesses mild thermal 
baths, having much the same qualities as those of that 
place, although it contains a few grains of common salt 
and a little carbonic acid. As the temperature of none 
of its wells exceeds 77 , it has to be raised for bathing. 
It is a place for those who want rest and quiet, and who 
find Wildbad too crowded. They have the advantage 
of having a muriated iron drinking well, which, if not 
very powerful, at all events has far more efficacy, than 
what often pass in this country for chalybeate springs. 

Teinach, fifteen miles from Wildbad, is a similar place ; 
but its waters, which have rather more mineral con- 
stituents, are cold. It also has an iron spring. 

Badenweiler, in the Upper Breisgau, an hour from the 



railway station of Miilheim, 1,450 feet above the sea, is 
described as lying in a most beautiful part of the Black 
Forest, with a very mild climate. It has for some time 
been a favourite German place of resort for diseases 
of the chest The baths have only a natural tempera- 
ture of 8i°; so they are heated artificially. It is only 
comparatively of late that this place has been resorted to 
for its thermal springs ; but it possesses many advantages 
of climate, scenery, and cheapness. The English have 
not yet found their way there in any great numbers. 

Warmbrunn, in the Riesengebirge of Silesia, at a height 
of 1,100 feet, with waters of a temperature of 95 to 
105 , is an old-established place, with admirable bath 
arrangements. It is visited in great numbers by northern 
Germans ; but its climate is somewhat severe, and as it 
lies quite out of the track of the English, it need not 
be further mentioned. 

Schlangenbady 900 feet above the sea, and not far 
either from Schwalbach or Wiesbaden, is a place for 
those to fly to, who cannot bear the overcrowding, that 
is met with at both of those stations during the season. 
It is as picturesque as a place can be on the small 
scale, with shady alleys and endless forest paths. The 
baths, which are used at a temperature of 88° to 93 , 
are beautifully arranged, and I can vouch for their 
pleasant feeling, though I leave it to the fair sex to 
vouch for their cosmetic qualities. They have a great 
reputation for quieting and strengthening the nervous 


system, and are resorted to very much by hysterical 
ladies, and ladies suffering from functional derange- 
ment of the uterine system. Skin complaints are also 
treated* here. Most English consider it dull. 

Bertrich. — This quiet little spot, in a volcanic valley 
off the Moselle, deserves a passing notice for those who 
like a quiet life and moderate living, and who require 
nothing more than an indifferent kind of water. The 
arrangements are comfortable ; the water is of the tem- 
perature of 90 , and contains more salts than most such 
waters, and it is mentioned here merely for convenience. 
Sulphate of soda, 7 grains ; carbonate of soda, 2 grains ; 
common salt, 3 grains ; and 4 J inches of carbonic gas in 
16 ounces. The spring was once hotter. 

In a far opener country than that about Wildbad, lies 
Teplitz, the type of waters of this kind; it and the 
adjoining Schonau possess probably more bathing 
establishments than any other bath in Europe. The 
waters are abundant, and the temperature high, and 
they are used of the highest temperature that can be 
borne. These baths have contributed mainly to esta- 
blish the reputation of indifferent waters. They have a 
special name, like those of Bareges, for being useful in 
the effects of gunshot wounds. Of late years, as in all 
the Bohemian baths, so here, peat baths have been an 
essential part of the treatment. 

The old town of Teplitz is somewhat dull and old- 
fashioned, as are its hotels, and the tide of visitors 

1 2 


has of late years flowed to the newer suburb of 
Schonau. The country around Teplitz is full of objects 
of interest; among them the most alkaline of the 
German springs, Bilin, rises almost under the shadow 
of a very striking igneous rock ; and in the immediate 
neighbourhood, in the forest of the Fichtelgebirge, is 
Eichwald, a place of resort in lung affections. That 
singularly picturesque district, the Saxon Switzerland, 
is easily visited from Teplitz. Teplitz is reached by 
a branch railway, from the line running between 
Dresden and Prague. The English do not appear to 
have visited it so much of late years. Everything 
that has been said about the effects of the indifferent 
thermal waters in disease, may be considered specially 
to apply to Teplitz, where the practical arrangements 
are excellent. 

Plombieres, in the Vosges mountains, at an elevation 
of 1,300 feet, reached easily from Paris and Nancy, is 
not known as much as it might be to the English. Its 
waters should be just as efficacious as those of Wildbad 
or Teplitz, and the establishments are admirable. I do 
not think I have seen any greater or more commodious 
baths than those of the Bains Napolexm. The water is 
so abundant, and its temperature so high, that it can 
easily be employed at any temperature wanted. There 
are several sets of baths in the town. 

The little town follows the bendings of a very narrow 
valley. All the old baths and old houses look much as 


they must have done in the days of Montaigne, although 
the curious practice, of grand seigneurs presenting to 
inns their Coats of arms cut in wood, has disappeared. 
There is much that is lively and pleasant about a French 
town, and those who go from year to year to German 
spas might try Plombifcres as a variety. There appears 
to be plenty of small gaiety, and amusement for young 
people, and the neighbourhood is very picturesque. I 
had occasion to prove the efficacy of the baths and 
douches in obstinate lumbago. There is an establish- 
ment for soldiers. Besides rheumatism and chronic 
joint affections, the French resort here for stomach com- 
plaints, and neuralgia and various diseases of women. 
It is specially contra-indicated in phthisis. 

Neris, in an uninteresting country in the department 
of Allier, has waters of a temperature of 113 to 125 , 
feebly alkaline, containing scarcely more than three 
grains of carbonate of soda and one of lime in the 
sixteen ounces. But the bath belongs to Government, 
and the bathing arrangements are very good. The 
waters, which were known to the Romans, are chiefly 
used as baths ; they have a great reputation for calming 
neuralgic and hysterical conditions, and are doubtless 
useful in rheumatism and in such uterine affections as 
mild thermal waters are applicable to. They are scarcely 
known to the English. 

Caldas de Oviedo, in the province of that name in the 
north of Spain, is a village in a cheerful country. The 


waters of this place are of the temperature of 108*5, 
feebly mineralized, but believed to contain a good deal 
of nitrogen gas. The waters are used in baths and 
douches, and also drunk. They are said to be 
diaphoretic and diuretic, and to excite the digestive 
functions moderately ; but the chief virtue of the waters 
is considered to reside in their nitrogen gas, which, 
employed in an inhalation-chamber, is used successfully 
in affections of the respiratory organs. Some years 
ago the number of visitors used to be 700 or 800 in 
the season, but I have not been able to see any late 
accounts of the place, or to learn that English have 
ever gone to it. There appears to be a fair bathing 
establishment The place has good air, and water, and 
provisions. Season from June to the end of September. 
Panticosa, which has an immense reputation in 
Spain in consumption, is situated high up among the 
Pyrenees, and is almost the highest bath in Europe, as 
there is but little difference in height between it and 
St. Moritz. After leaving the village of Panticosa, you 
pass for one and a half or two hours through a narrow 
gorge in most savage and broken mountains, called 
the Staircase. At last the road turns sharply, and 
you discover a group of houses forming the thermal 
establishment. Their base is washed by a small, deep 
blue lake, into which some magnificent cascades fall. 
The establishment is one of the best in Spain. The 
place is small and shut in ; there is only one short 


walk in the vicinity, and just room to turn a boat in 
the lake. 

The principal sources are four in number: that de 
la Lagiina, or of the tank ; del Estomago, of the 
stomach ; de los Herpes, of eruptions ; and del Higado, 
of the liver. The water most used for baths is the de 
los Herpes, and on its account a notice of Panticosa 
finds its place here. Considering the weak minerali- 
zation of these waters, it seems impossible that their 
virtues can depend on it; much must be attributed to 
the altitude of the place. The climate is represented 
as comparatively mild, the thermometer never rising 
above 86°. The waters are employed for drinking, 
for bathing, and for the inhalation of nitrogen. The 
chief diseases treated here are chronic affections of the 
chest, loss of voice, phthisis, and stomach affections. 
The season is from July to the end of September ; the 
place is of course deserted in winter. It is visited by 
French and English, chiefly as a curiosity, owing to 
its elevated position, but is in growing repute with 
Spaniards. The arrangements are said to be very fair, 
but rather of a primitive description ; nevertheless it has 
about 1,000 visitors annually, chiefly Spaniards, and of 
the higher ranks. One of the great drawbacks of Panti- 
cosa is the tiring journey to it for invalids. It is more 
accessible from the French than from the Spanish side. 

Buxton, in Derbyshire, at nearly the same elevation as 
Schlangenbad, while its wells are very similar, .enjoys a 


more bracing climate, a great advantage at the season 
when baths are visited, though not so in winter. The 
arrangements at Buxton are excellent, and it has long 
deservedly enjoyed a great reputation in chronic rheu- 
matism and gout; the natural heat of the waters is 
8i° to 8 2 , and it is raised when necessary. To those 
who prefer staying at home, Buxton, with its interesting 
neighbourhood, presents many attractions; it produces 
all the good effects of the less stimulating indifferent 
waters, and its chief recommendation, as compared 
with continental baths, is, that going to it saves a long 
journey; but living at it costs more than almost any- 
where abroad. Matlock, with water of 68° and lovely 
scenery, is analogous to Buxton. 

We come next to the earthy thermals. 

Among them are the springs of Pisa and the better 
known hot wells of Lucca. These baths, with a won- 
derfully temperate climate during the fine season, 
situated in a beautiful valley, some fifteen miles from 
Lucca, have been long great places of resort. Mon- 
taigne has given us a very full account of his experience 
of its waters. 

The hottest spring is n 6°. The wells contain about 
eighteen grains to the pint of solid constituents, some 
twelve of which are sulphate of lime. They are used 
much more for baths than for drinking. Their effects 
are the same as those of Bath or Leuk, and all the 
benefits to be procured from indifferent waters in the 


plains may be obtained here, but they have never been 
favourites with they English, as they always migrate to 
the north before the season, when the baths of Lucca 
become available. June to September is counted 
the bath season; the baths are on a very extensive 
scale, and there is ample provision for the poor. 
Lucca is healthy, and the neighbourhood is picturesque. 
All Florence goes to it in the season, but they go for 
coolness and for society rather than to use the baths. 
Every convenience of life is to be had here as well as 
in Florence. It is therefore the most comfortable of 
all the Italian baths, and it is a cheap place. 

Baths of Bormio. — While the flow of English travel- 
lers sets in towards St. Moritz and Eastern Switzerland, 
and while consumptive patients are sent to Alpine 
climates, the baths of Bormio, " II paradiso delle Donne," 
with the milder climate of the southern side of the Alps, 
should not be overlooked, as they are not far distant. 
They are situated on the Italian side of the Stelvio 
route, the highest over the Alps, at a height of 4,400 
feet, and in the midst of the most grand scenery. 
The old bath is some 500 feet higher than the new 
one. The new bath was started by a Swiss company, 
and every comfort is to be got there during the season, 
which lasts from 15th June to 15th September. The 
baths have been used for many centuries by Italians, 
and by the country people, and have a reputation among 
them in paralysis, rheumatism, hysteria, and sterility, 


also in spleen and other results of malaria poisoning. 
It is easy to see in what cases baths varying in tem- 
perature from 86° to 104 at such an elevation, are 
applicable. They contain about eight grains of solid 
constituents to the pint, six of which are sulphate and 
carbonate of lime. Probably very few English have yet 
found their way to these baths. The mildness of the 
climate may be inferred from the fact, that May used to 
be the favourite month for cures. 

The baths of Leuk are accessible enough, not being 
many hours' drive from the station of Sion. They lie 
in a valley at the foot of the pass over the Gemmi, 
at a height of 4,386 feet above the sea. The climate, 
an Alpine one, is rather subject to extremes. The waters 
are nearly indifferent, but contain some eleven grains 
of sulphate of lime in the sixteen ounces; they vary 
in temperature from 93 to 123 . They are greatly 
frequented, but chiefly by Swiss and French. Few 
English go there, except to see the place as a sight. 

It differs from other baths in the old habit of long- 
continued immersion being kept up. The baths are 
common, and persons of both sexes, in long bathing 
gowns, frequent the same bath, and spend hours 
together, eating, reading, and playing chess on floating 
boards. Patients are warned to be careful about the 
bath which they select in the first instance, as it is 
difficult afterwards to make any change, without giving 
offence to your neighbours. I fear that the visitors 


are apt to be disputatious, as the police regulations 
order that there are to be no discussions on religious 

The same cures are produced by the Leuk as by 
similar indifferent waters, but the speciality of the place 
is the effect on the system of long-continued immer- 
sion in water of the temperature of about 97 . It is 
possibly on this account, and according to Hebra's 
views, that these waters have always had a great repute 
in skin complaints. They are found very efficacious 
in eczema, impetigo, lichen agrius, and ecthyma, while 
they are of less use, like all other remedies, in those 
obstinate complaints, psoriasis and lepra. The water is 
also drunk, but there is difference of opinion among the 
local physicians, as to its efficacy and its use in dyspepsia. 
The bath season extends from June to September. The 
months of July and August are counted the best. 

Some of the English who pass to or from Italy by 
Aosta, maybe tempted to stay and enjoy the magnificent 
scenery, and the mountain air of Courmayeur and Pre 
St. Didier, which is close to it. The waters of this place 
have a temperature of 96 . They contain not very 
much saline matter, and in it carbonate of lime pre- 
dominates. These waters have a considerable reputa- 
tion, chiefly local, in rheumatism and contraction of 
joints, in cutaneous and in nervous affections. They 
are used mainly in baths. I wonder that English do 
not linger more on their way north at these Italian 


Alpine baths. There is plenty of excellent Italian 
society at the neighbouring ^Courmayeur. 

St. Amandy lying on the Scarpe in the north of 
France, enjoys a reputation for its mud baths. There 
is an excellent thermal establishment, one of the best 
in France. The waters, temperature 67 — 77 , are weak 
sulphated ones, and give out a slight sulphuretted 
hydrogen odour. These waters permeate the layers of a 
peculiar elastic soil, and this, in the shape of mud, is 
used for baths, for which purpose it is collected in one 
large glass rotunda. Each patient has a separate 
division of this fluid mud, and its use is specially 
reserved for him during the season, as it is not renewed. 
As the natural temperature of the mud is not high 
enough for most people, it is usually artificially heated. 
Patients remain for some hours in these baths, doing 
their best to amuse themselves, until they can quit 
them, and purify themselves in a bath of fresh water. 
These baths have a great name in rheumatism, thicken- 
ing of the joints, paralysis, and congestion of the liver, 
in fact in much the same cases as the mud baths of 
Acqui and Albano and the peat baths of Germany. 

Bagneres de Bigorres. — This popular bath will be men- 
tioned again under another head. It is noticed here 
owing to the virtues of its two chief bathing wells : the 
Foulon, temperature 91*4, and the Salut, temperature 
89*6. The supply of the first is rather scanty; the 
latter is more abundant, and its waters are also drunk. 


They both contain a variety of salts, but in very 
small quantity, and their action must be considered 
indifferent They are often found to be efficacious in 
much the same cases as Schlangenbad, and the waters of 
the Foulon have something of the pleasant feeling of the 
water of that place. They are considered to be sooth- 
ing to the nervous system. It is doubtful whether this 
bath should not, so far as the remedial effects of 
bathing go, be classed entirely among earthy bathing 

Sacedon, on the upper part of the Tagus, not very far 
from Madrid, has of late years become a very popular 
bath. It seems to be a pleasant place of residence in 
a pretty country, with walks in the royal gardens, with 
Roman remains, and a fine gorge in the mountains, 
to make excursions to. These waters, which are weak 
sulphate of lime, were known to the Romans and to the 
Arabs. They are chiefly used for bathing purposes ; 
their temperature is 85 , so that for some cases they 
have to be artificially heated. They are used in rheu- 
matism and in cutaneous affections. 

Bath possesses the only springs of any considerable 
temperature in Great Britain ; the hottest is 117 . 
According to early records, the ladies and gentlemen 
used to enter a common bath in a state of nature. After 
a time they were induced to adopt decent clothing, but 
they still resorted to common baths, and spent many 
hours in them, just as they do now at Leuk. 


But Bath, once as crowded with visitors as the most 
fashionable spa, has fallen from its high estate. Its 
waters are now litde employed, not that they are not as 
efficacious as ever, and quite as powerful as any other 
waters of their class, for, notwithstanding the presence 
of a little gypsum, and some other solids, they must be # 
considered indifferent waters. Bath is one of the few 
places, where a cure can be conveniently carried on 
during the winter, and it possesses one of the best 
English winter climates. Altogether, the fact that Bath, 
presenting so many advantages of climate, and of cheap 
living, and of pleasant if not "fast" society, should 
have been abandoned, in spite of its thermal springs, 
is very remarkable. It must be attributed partly to " 
fashion, and partly to the city having grown too large ; 
few baths continue very popular, after a large city has 
sprung up around them.* 

To these earthy thermal springs may be added Clifton, 
with wells of 74 , and the only Irish warm one, Mallow \ 
where the water has a constant temperature of 69 . 
The last is pleasantly situated, and was at one time in 
repute for its baths, but is now little known. 

* The sketches of Bath life given by our old novelists, and by our 
professional writers, are very amusing. One of the latter, stigma- 
tizing the practice of forcing pills and quack medicines on those 
frequenting the baths, mentions in the following ludicrously serious 
terms one of the girls employed in hawking these medicines : — 
" Molly Lawrence, whose most agreeable, graceful exterior person 
gives indications of what her conduct proves, a sensible and well- 
disposed mind." 



All the effects produced by the indifferent thermal 
springs may also be obtained from the sulphurous ones, 
which are very weak solutions of sulphur in combination 
with alkalies, or of hydrosulphuric acid — such very weak 
solutions, that one wonders whether the sulphur has 
any operation at all; but certain special actions on 
the cutaneous and bronchial surfaces are attributed to 
these waters. While there is much difference of opinion 
as to the share which sulphur has in their operation, 
yet it is proper for the present to describe the effects 
usually attributed to its presence. 

Sulphur baths of the temperature of 90 to 95 excite 
the nervous system slightly, make the circulation more 
active, render the respiration lighter and easier, and 
produce a desire to make water. Sometimes their con- 
tinued use causes languor and loss of appetite for a 
few days, and baths, especially of a higher temperature, 
produce a slight eruption, to which much importance has 
been attached, called lapoussee. A very slight degree of 


irritation of the conjunctiva is also said to be an occa- 
sional effect. Further effects are, increased frequency of 
the pulse (though the latest observers say it is retarded), 
increased cutaneous transpiration, while the urinary and 
bronchial secretions are augmented. The specific gravity 
of the urine is usually diminished, while the urea and 
uric acid are increased, and the phosphates and sulphates 
are lessened. The change of tissue is thus quickened, 
the sanguification is more rapid, and under these in- 
fluences chronic indurations often disappear. The 
appetite and digestion are improved. Such is about 
the standard account of these things, but exact obser- 
vations are wanting. 

Although it is the tendency of modern dermatologists 
to throw off all faith in sulphur waters, we cannot wait, 
if they are really useful, till a satisfactory rationale of 
their use is supplied, especially as dermatologists are 
far from being at one among themselves, and not 
even agreed about the classification of many of the 
commonest forms of cutaneous affections. 

The writers on the Pyrenean waters explain the cures 
which they effect with them, on the theory that they 
act by modifying various constitutional states, of which 
the cutaneous affections are merely expressions. And 
these states they have called the scrofulous, the gouty, 
the dartrous, or the herpetic, and the syphilitic. The 
subject generally has attracted much attention in France of 
late years, and Bazin has attempted to demonstrate, that 

SULPHUR BA Tf/S. i 29 

sulphur cannot possibly have any operation against 
those various states or diatheses, although he considers 
eruptions to be the result of general constitutional 

Durand-Fardel goes further back, and refers all 
cutaneous affections to alterations of the blood and of 
nutrition, thus recalling to us old notions of acidity or 
alkalinity of the system, and the corresponding use of 
alkalies or of acids. But the subject cannot be pursued 
further in this place. 

The dartrous condition is one, however, so little 
recognised in English medicine, yet so constantly referred 
to by French writers, that some of its main features, as 
described in a recent work, may be enumerated. It 
comprises a great majority of cutaneous affections, 
humid and dry, various affections of the eyelids, of the 
external ear, and of the aural passages, granular sore 
throat, dartre of the nose, certain asthmas, certain 
chronic bronchi tic affections, some affections of the 
stomach, a great many disorders of the genito-urinary 
organs of men and women ; in short, a general irrita- 
bility of skin and of mucous membrane seems to be 
described, approaching, perhaps, to what we might 
call, catarrhal* 

But passing from such theoretical considerations, I 
think that it must on the whole be admitted, that 
cutaneous affections are often ' benefited by sulphur 
waters, or by the treatment which they receive at some 



of the principal sulphur baths. Many chronic skin 
diseases — such as eczema, impetigo, prurigo, psoriasis, 
and lepra — frequently improve. 

It appears to be mainly by their action on the skin, 
that sulphur waters have also been found useful as a sort 
of test for latent syphilis, their use frequently bringing 
out eruptions that were dormant I have known some- 
thing analogous, in the way in which sulphur waters have 
brought out patches of Lichen circumscriptus of former 
years. As to the absolute curative effects of these 
waters, they only appear in syphilis in its secondary 
forms, and then not very remarkably. Their employ- 
ment in the form of baths, in such cases, is at most 
an adjunct to the use of iodide of potass, and of other 

It seems to be admitted on all hands, that sulphur 
waters are useful in eliminating metals in cases of metallic 
poisoning ; but as direct absorption of sulphur, and even 
of any quantity of hydrosulphuric acid, through the skin, 
is out of the question, this result, so far as it is not com- 
mon to all other bath treatment, must be attributed to 
the drinking of sulphur waters* 

Many of the Pyrenean waters are counted very 
efficacious in functional uterine disorders. 

Another use to which sulphur waters are constantly 
put in modern times, is in the form of inhalations 
consisting of vapour impregnated with hydrosulphuric 
acid. Judging by their universal employment abroad, 


they must be found useful in chronic laryngitis and 
bronchial affections, if not in incipient phthisis, as has 
been thought. The rationale of this is not yet 

The Pyrenean is far the largest group of sulphur 
waters known. There are no mineral water stations 
with 500 springs on the French side of the Pyrenees, 
and there are said to be more on the Spanish. 

Bareges, the most celebrated of the Pyrenean baths, 
appears to owe nothing to the beauties of nature or to 
its climate, which is variable. Its inhabitants have to 
emigrate in winter. The supply of water is so scanty, 
that the wants of patients are with difficulty supplied. 
In spite of all these disadvantages, and that its cures 
are effected chiefly by immersion in crowded piscinae, 
no waters are in greater repute for the cure of certain 
ailments ; and at the head of these stand, old wounds 
and cicatrices, and chronic diseases of bone; in rheu- 
matic and neuralgic affections the action of the waters 
is also powerful ; in fact, very much the same cases are 
treated here as at Teplitz. 

The waters, which are very feebly mineralised, and 
contain the half-organic substance baregine, are con- 
sidered the most exciting of the Pyrenean baths : no 
doubt the height of the place has a good deal to 
say for this ; they are used for drinking, but their chief 
employment is in baths. 

The colder waters are first used, and then you go 

k 2 


on to the hotter ones; the temperature ranges from 
87° to 1 1 3 . Barfeges is reached by carriage from the 
railway station of Lourdes, but it is only in very special 
cases that English are likely to resort to it The 
arrangements are better than they used to be. It has 
a military hospital, and the season is July and August 

Cauterets lies in a picturesque narrow valley on the 
banks of the Gave ; mountains shelter the place from 
winds, and render its climate mild and less variable 
than might have been expected; its wells are very 
numerous and scattered, but, having been recently 
leased to a new company, will have the advantage of 
having their management systematized and amalga- 

Though its baths are used for all the purposes for 
which other sulphur waters are employed, the repu- 
tation of Cauterets rests chiefly on its beneficial effects 
in tubercular and bronchitic affections. It has a great 
reputation in the diseases of women, who employ the 
waters in baths and in local douches, and also drink 
them. It is said that mules in Tarbes and Pau, 
suffering from bronchial catarrh and from diarrhoea, 
when sent up to Cauterets, mend rapidly. 

The baths may be divided into three groups, — the 
eastern, the western, and the southern. Of all the 
springs, a western or south-western one, La Raillfere, 
is far the most frequented ; and the crowd of patients, 
in the most different costumes, ascending the hill to it in 


every variety of conveyance, is said to be one of the 
most amusing scenes in the Pyrenean baths. The 
season commences in May and lasts till October; it 
is often very crowded; as many as 15,000 guests have 
visited it in a season : it is reached in 8 hours 30 
minutes from Lourdes. 

St Sauveur, at a height of 2,525 feet r with not so 
unsettled a climate as many mountain places, appears 
to have little sulphuretted hydrogen in its waters, but 
is a fashionable bath. The water is soft and pleasant 
to the skin. In many respects it may be considered 
the French Schlangenbad. It is good for nervous 
patients, likewise for complaints of females, and is 
essentially a ladies' bath ; it has the advantage of being 
close to some of the finest scenery in the Pyrenees. 
The temperature of the water varies from 8i° to 135 , 
and it is chiefly used in baths, although it is also used 
internally, often mixed with milk or gum-arabic. The 
season commences in May and ends in October; it 
is approached like the other baths from Lourdes. 

Eaux Chaudes, subject to rather sudden changes of 
temperature, is situated in a savage, picturesque, and 
very narrow and gloomy gorge, where the houses can, 
scarcely find room. Notwithstanding its thermal estab- 
lishment built of marble of the Pyrenees, it is not very 
much resorted to. Although it is used for chronic 
rheumatism and for chlorotic complaints, its baths seem 
mostly to serve as a supplement to the neighbouring 


Eaux Bonnes, where the waters are chiefly drunk. The 
season is from ist of June to ist of October; it is 
reached by diligence from Pau. 

Bagrikres de Luchon, — Climate mild, but, like most 
Pyrenean ones, changeable. This and the Bagneres de 
Bigorres are by far the most important of the Pyrenean 
baths for the English, as they are the only ones which 
supply all the comforts they look for; and with the excep- 
tion of not being aided by the Alpine air of some of 
the higher stations, owing to their being only 2,000 feet 
above the sea, its various baths produce all the effects 
that are to be expected from sulphur waters. They 
are situated in the midst of the most magnificent 
scenery. The bath establishments and drinking arrange- 
ments of Luchon are excellent. The waters of Luchon 
and of some other sulphur baths have the property of 
getting white or milky after exposure ; this is from 
the deposit of sulphur, but chemists have not made 
.out very distinctly the cause of this phenomenon. 

They profess to cure here all the complaints in 
which thermal springs are useful ; but specially skin 
affections. Each of the many wells is believed to 
have peculiar virtues, and to be most useful in par- 
ticular forms of disease; but such details cannot be 
entered into here. 

Piscinas or common baths are still in use here and 
objected to by many, but infection through such sources 
is absolutely unknown. Luchon is reached from Mont- 


rejeau in 3 hours 15 minutes. The season is from 
15th June to 15 th September. 

Amelie les Bains, about 800 feet above the sea, 
reached by carriage from Perpignan, lies in a romantic 
situation, with lofty masses of rocks, and streams flow- 
ing from them ; deserves notice chiefly, as one of those 
places in which every possible arrangement has been 
made, for presenting the fumes of sulphuretted hydrogen 
to the patient in a variety of ways. The temperature 
of the springs varies from 92 to 145 . 

There is probably no place on a small scale where 
the arrangements of this kind are better. The French 
have retained it for one of their permanent military 

It is resorted to for rheumatism, but more especially 
for the early stages of pulmonary consumption; and 
owing to the mild climate of the place, patients are 
able to stay there during the winter. 

Amelie les Bains may be considered as a representa- 
tive of the sulphur baths of the Eastern Pyrenees. They 
do not differ in essentials from other baths, except in 
their mild climate, and therefore in being, some of them, 
fit for a winter residence for invalids. 

Very hot vapour baths and inhalation rooms form an 
important part of the curative process. The treatment 
is mainly by bathing, but the waters are also drunk, and 
are believed to increase the secretion of urine, and even 
favour the solution of gravel. It is complained, that they 


do not understand mulling and kneading the muscles here. 
Notwithstanding that all writers are agreed in praising 
the arrangements of this place, it does not appear yet 
to have received a proportionate number of annual 
visitors, but of late years over 400 have spent the 
winter at it. The regular season extends from May 
to the end of October. 

Le Vemet, with many points of resemblance to Am^lie, 
lies higher, at an elevation of 2,000 feet ; like it, it has of 
late years become a place of winter resort, but, though 
sheltered from the east and from the enervating south 
wind, it is open to the north, and in December and 
January owing to the neighbourhood of the mountain 
of Canigou and others, it only sees the sun for one 
hour or two. But to make up for this, there are inha- 
lation chambers of regulated temperature, for winter 
patients, and the climate is very pleasant in spring 
and in autumn. 

Ax, in the Eastern Pyrenees, has, perhaps, the 
largest supply of thermal sulphur waters in Europe, and 
the hottest in the Pyrenees. It is as picturesquely 
situated as Luchon, and though the village is a miserable 
place, very fair accommodation is provided for visitors, 
who now reach an annual average of 2,500. Although 
it is declared by chemists that the waters of Ax have 
not quite so much sulphuret of soda as those of 
Luchon (the quantity in the latter not amounting to one 
grain in the sixteen ounces), I think it is of very little 


importance, as there is no doubt about the extrication 
of an abundant supply of hydrosulphuric acid. There 
are three bathing establishments, and a military hospital. 
It is reached from Foix. 

Escaldas, up among the mountains, is also very 
picturesquely situated, not very far from Ax. Out of 
the way though it is, it receives a contingent of 700 
visitors every year, chiefly from across the Spanish 
frontier. In spite of its high position its climate is mild 
during the season, and it is resorted to for bronchial 
catarrhs as well as for skin complaints. It is reached 
from Perpignan. 

Aix les Bains. — There is probably no sulphur bath 
where the arrangements are more complete than here. 
Separate baths, baths in common, baths for men and 
baths for women, every variety of douche and of vapour 
baths, not forgetting the local and general application of 
water and of steam, and inhalation chambers,, are all 
met with. The supply of sulphuretted water of a high 
temperature is so abundant, that there is. no necessity 
for utilizing it carefully as in places like Bareges. Add 
to this, that the town is in a beautiful neighbourhood, 
and very near some of the pleasantest scenery in the 
Alps, that living is moderate, and that there is agreeable 
society, and it will be found on the whole to be one 
of the most convenient places to which the English 
can resort. It is reached by railway from Lyons or 
from Geneva, being on the main line to Mont Cenis. 


Aix can be visited earlier in the season than some of 
the more northern baths. It gets hot in July and 
the first half of August, but after that can then be 
visited again. Everything that can be effected by skill 
in application of thermal waters, is to be obtained here. 

Marlioz, a pretty little village quarter of an hour's 
drive from Aix, is nicely laid out, and makes a pleasing 
variety from Aix. It has extensive arrangements for 
pulverizing its waters and for inhaling rooms, and is 
trying to establish a name in laryngeal and bronchial 

In these days, when the magnificent island of Corsica 
seems likely to be opened out as a health resort in chest 
complaints, its mineral resources must soon attract 
notice. It has various excellent sulphur baths, which 
have been long in use. 

Pietrapolo, temperature no° to 146 , much frequented 
with good arrangements; fine thermal establishment, 
and in picturesque country among the mountains. 

Guagno y temperature 105^8°, although selected for a 
military hospital, is represented as gloomy, and the 
arrangements are very imperfect. 

Guitera, temperature 104 to 131°, with an immense 
supply of water, is very promising, but accommodation 
for visitors has still to be supplied. 

Puzziehdlo, cold, has great local reputation and very 
fair arrangements. Its effects are said to resemble 
much those of Schinznach, and it is used mostly in 


■ -- 1- r ----- -- . 1 i_ 

cutaneous affections, but its low situation exposes it to 
the effects of malaria at certain seasons of the year. 

Baden in Switzerland, on the railway near Zurich, 
is one of the oldest and most visited baths in Europe ; 
but rather a resort of French and Swiss than of English. 
It is in a pleasant country, and the arrangements are 
very convenient, the waters being abundant, and baths 
attached to all the hotels. The town is somewhat old- 
fashioned. There is no great variety of amusements, 
and it is a place only to be visited by those who really 
have need of its waters. The quantity of hydrosulphuric 
acid in its waters is very trifling. Their effects, therefore, 
are chiefly those of thermal waters ; they are also used 
for drinking, but the thirteen grains of common salt in 
the sixteen ounces of water, a weak enough dose, is 
balanced by thirteen grains of sulphate and carbonate 
of lime ; so that it is not surprising that it is not borne 
well by many stomachs. One cannot but be amused at 
the praises lavished on the many delights of Baden 
by Meyer-Ahrens, but he will not convince the world 
that the place is not dull. 

Schinznach, only a few miles from Baden, is more 
picturesquely situated, and has more complete public 
arrangements. Here there are no private hotels, the 
whole establishment belonging to the canton ; the 
arrangements are excellent, but this also is a place only 
to be visited by invalids. The waters contain more 
sulphuretted hydrogen than most baths on the Continent, 


excluding some Hungarian ones; but their temperature 
not being high, it is necessary to heat them. At Schinz- 
nach they pay much attention, and successfully, to 
cutaneous disorders. The quantity of lime is much 
less than in the waters of Baden, and there are in the 
sixteen ounces of water some seventeen grains of sul- 
phate of soda, and other soluble salts, so that some 
effect may be produced on the digestive organs by 
their internal use, especially with the additional employ- 
ment of the strong chloride of sodium of the neighbour- 
ing Wildegg, which contains some iodine. 

Baden in Austria is one of the largest baths in Europe, 
and all the arrangements are on a magnificent scale. 
There are enormous swimming baths, and common ones, 
in which men and women spend many hours. 

It is a place of great resort to the people of Vienna ; 
not much visited by the English. The waters are rather 
weak, and the place is more one for strangers to go 
to see, than for those who are seriously in quest of 
health, to resort to. It contains somewhat more sul- 
phuretted hydrogen than its Swiss namesake, but its 
temperature of 95 does not come up to the high tem- 
perature, 1 1 5 , of the latter. 

Aix-la-Chapelle, or Aachen, in Rhenish Prussia, on 
the route between Antwerp and Cologne, and with its 
neighbouring Burtscheid, almost identical in its waters, 
except in their heat, rising to 166 , has, owing to its 
abundant supply of waters of high temperature, long 


been the chief sulphur bath of Germany, and well 
known to the English. The arrangements of every 
kind are excellent, and the douches certainly second 
to none in Europe. Every effect that sulphur baths, 
not at a great elevation as some in the Pyrenees, can 
produce, may be procured here, but rheumatism and 
cutaneous affections are the complaints probably most 
successfully treated ; being a bath of established reputa- 
tion, it has a staff of very experienced officers, whose 
practice in a large city like Aix is not limited too much 
to one set of diseases as at most baths. 

The season lasts from June to the end of September, 
but the baths are open all the winter, and owing to their 
excellent arrangements may be very well used at every 
.season. The new Kaiserbad is in all respects one of 
the most complete in Europe. The chief disadvantage 
under which Aachen labours is that, owing to the pros- 
perity of its manufactures, the town has greatly in- 
creased in size, and become so large, that those who 
visit it, have not the advantage of large pleasure- 
grounds or shaded walks near the wells, which they 
have in some other baths. But these waters will be 
mentioned again, as their internal employment co- 
operates with their external application in a more tangible 
way than is the case with most sulphur waters, the 
mineral constituents of which are often almost nil. 

Italy can boast of many excellent thermal sulphur 


Acquis not very far from Alessandria in the north of 
Italy, has been used at least since the days of the 
Romans. There are many springs, of which the most 
abundant emerges at the high temperature of 169°. 
Its main constituents, besides hydrosulphuric acid, are 
chloride of sodium and a little lime. The water is 
limpid, and soon parts with its smell of hydrosulphuric 
acid. These waters produce all the curative effects of 
other hot thermal waters ; and they are remarkable in 
another respect, as being like the baths of Abano and 
of St. Amand, the prototypes of the German mud-baths. 
The favourite mode of bath here, is for the patient to 
have the affected parts covered with a layer of soft 
incrustation, brought up by divers from the bottom of 
the well. An abundant vapour exhales from it, and . 
converts the room into a regular vapour bath. A 
patient remains with the part enveloped for three- 
quarters of an hour or an hour, after which he cleanses 
himself in a bath of the mineral waters. 

The baths of Abano and Battaglia, six miles apart, 
in the Euganean hills, not far from* Vicenza and 
Padua, contain more common salt than the waters of 
Aix-la-Chapelle, and quite as much hydrosulphuric 
acid. There was once a temple here connected with 
the waters, where oracles derived from the state of 
the spring were delivered. The baths are deservedly 
much frequented, though not by English. The tem- 
perature of the hottest spring, is as high as 185 . 


In spite of this great heat confervse and bacterias live 
in it. Besides the employment of baths and douches, 
the mud of the baths is applied topically. There are 
shady walks about, and the ordinary sources of amuse- 
ment. The climate is mild and temperate, but at 
times apt to be very hot. The accommodation at 
Battaglia is much better than at Abano. It is a pretty 
place with luxuriant vegetation. 

There are many hot sulphur springs in the Padua 

There are many excellent thermal sulphur springs 
in Spain, but most of them in out-of-the-way places, 
as in Gallicia, quite out of the beat of the English. 
One near Santander is most in their way. While the 
arrangements of most of the Spanish baths remain as 
they are, it is only very adventurous people, who will 
venture to any of them far removed from ~the beaten 
tracki Some of the chief are : 


Archena, in M'urcia . . . . . . 126*5 

Cuntis, near Pontevedra 68 to 140 

Carballo, near Corunna 77 to 97 

Cortegada, near Orense 84 to 90*5 

Ontaneda, near Santander .... 77 to 100 

Ledesma, near Salamanca . . . . 86 to 122 

The first of these has a special reputation in the cure 
of syphilis, and the last is one of the most frequented 
baths in Spain. 



In parts of the Continent far removed from the sea, 
the salt springs are in great repute, and sool bdder, as 
they are called, are extensively used. They are of less 
importance to the French and English, who have a large 
supply of sea-coast watering-places, where by proper ar- 
rangements every effect produced by the salt springs may 
be obtained. 

The stronger ones are most of them artificially pre- 
pared ; that is, a weak spring is strengthened by adding 
the salt mother liquor, as they call it, and too strong a 
one is diluted. Their efficacy depends on the stimulation 
of the skin, and the degree of this depends on the 
strength of the bath, on the length of the immersion, and 
much also on the skin of the patient. The sensibility of 
the skin depends partly on age, and partly on individual 
constitution: 2 to 3 per cent, is the average for most 
people, while 10 per cent, of salt in the bath produces 
over-stimulation of the skin; an advantage which these 
waters possess over indifferent ones is, that with a lower 
temperature they produce as much stimulation of the skin. 


It seems probable that no portion of the salt is ab- 
sorbed, although it is a matter of ordinary experience, 
that a certain amount of it adheres to the cuticle. Some 
of these springs owe most of their reputation to the 
supposed absorption of the iodine or bromine which 
they contain; but even if the minute quantities they 
hold in solution were absorbed, their amount is so 
small, that they could not be reasonably supposed to 
act on the organism. Salt baths are believed to act 
primarily on the skin, and to favour the transformation 
of tissue. During their use the appetite and powers of 
digestion increase, and experiments would seem to show, 
that an increased secretion of urea is a result of this 
quickened oxidation. 

Scrofula has long been considered specially under the 
influence of sea air and of salt water, and of their use 
in it there is no question, though their action is greatly 
helped by the internal employment of medicines, to 
assist in the resolution of swollen glands. 

It is probably owing to the favourable influence which 
they exert on anaemic conditions, that salt baths are in 
great repute in many of the sexual diseases of women, 
chiefly in those depending on debility; they are said 
to disperse indurations of the uterus and of the ovaries ; 
nay, there are not wanting accounts of fibrous tumors 
of the uterus, and even of cancer of the breasts, being 
cured at Ischl and at Kreutznach : but such statements 
must be received with much caution. 



The list of diseases to be cured by these baths, if we 
take the accounts of the local doctors for granted, is 
enormous, and cannot be accepted; but, among them, 
there is no doubt that they are useful in chronic rheu- 
matism and in gout Much in such cases depends on 
the temperature of the baths used : where the tem- 
perature is high, some of the weaker saline baths, 
such as Wiesbaden and Baden Baden, are among the 
more efficacious ones for gout. But it must be considered, 
that their qualities in this respect are mainly the same 
as those of the indifferent baths, especially in the case 
of Baden Baden, where the quantity of salt is so 
small. It is no doubt owing to their temperature, 
that the baths of Bourbonne, like indifferent springs, 
have got a reputation in paralysis and old wounds. 

Salt waters may be divided, with reference to baths, 
into — i, weak; 2, carbonic acid ones; 3, strong ones; 
4, sea-water. 

And first of weak ones. In studying their effects, 
two points, besides the quantity of salt they contain, 
have always to be borne in mind — the temperature at 
which they are used, and the quantity of carbonic acid 
that they contain, as a good deal of that gas is neces- 
sarily lost in heating the colder waters to a proper 
temperature for baths. 

Wiesbaden, one of the most important thermal baths 
of Europe, visited by 15,000 to 20,000 guests annually, 
is the capital of Nassau, and lies in a valley only open 


to the south ; it is easily reached from all quarters by 
railway. The climate is not an extreme one, and in 
winter is mild for Germany, and many foreign families 
are beginning to make it their winter residence. Like 
almost all continental baths, it is for a time in summer 
intensely hot. The water is very abundant, and almost 
all the hotels have baths in them, or in their close 
proximity. There are no fewer than seventeen sources 
of warm water. Only one of the wells, the Koch- 
brunnen, is used for drinking. The waters contain 
from 45 to 58 grains of common salt in 16 oz. The 
hottest of them has a temperature of a 5 6°. 

The general effects of the waters of Wiesbaden are 
pretty much the same as those of indifferent waters, 
and many of the cases that are sent to Teplitz might 
be very well treated here; but the appliances, in the 
way of douches and local treatment, do not appear to 
be as complete as in Teplitz, Wildbad, the two Aixs, 
and some other places. Wiesbaden has a great repu- 
tation for gout, as Aix-la-Chapelle has for rheumatism : 
there may be an opportunity afterwards of examining 
how much of this is owing to the internal use of 
these waters. Wiesbaden is provided with very pleasant 
gardens, a handsome Cursaa/, and gamblingrrooms, so 
that it offers inducements to -people of all tastes. The 
town is not striking, nor is its neighbourhood, but it 
is a very comfortable place of residence, in which 
one can live cheaply or expensively, according as he 

L 2 


manages ; and its convenient situation near Mayence 
and Frankfort will always make it a great place of 

Baden Baden, far the most picturesque and pleasant 
bath in Europe, is easily reached by railway through 
Strasburg. It is a pleasure and gambling resort, rather 
than one for health; still most of the advantages of 
an indifferent bath may be had there. Chronic rheu- 
matism and gouty cases, that would not bear more 
active treatment, are often sent to it with advantage. 

It remains to be determined, whether the unusual 
amount of lithia in die Murg well here is of any real 

The climate of Baden is warm, and the place is 
sheltered, and there is abundance of amusement to 
be had, so that persons merely requiring relaxation 
and change of air, without having anything specially 
wrong with them, cannot be sent to a better place. 
Every one likes Baden. 

Bourbonne les Bains, in the Haute Marne, is one of 
the chief French salt waters. It is a small town agree- 
ably situated outside the Vosges Mountains. Its waters 
contain about as much salt as those of Wiesbaden — 
46 grains of common salt, 14 grains of lime salts, bromide 
of soda, 0*38, with a good deal of nitrogen and of car- 
bonic gas. Its waters are quite sufficiently warm (tem- 
perature 1 1 4 to 1 47 ) ; and as the two places fulfil very 
much the same indications, it has sometimes been callecL 


the French Wiesbaden. In both places the bathing 
is generally associated with drinking the waters ; but 
Bourbonne must have improved greatly, if it be nearly 
as pleasant a place of residence as its German compeer. 
There is a military hospital here, and it is worth while 
to remark that the baths have been found efficacious in 
rebellious malarious fevers, and in the visceral engorge- 
ments of the abdomen, which occur in soldiers who have 
served in Africa. 

Bourbon PArchambault, reached vid Moulins, with 
weaker salt waters, and with a military hospital, was 
formerly in great repute; but it is a dull place. The 
curious practice of performing scarification, after ex- 
hausting the air by suction through a horn, used to 
be employed here. 

Balaruc, situated on the edge of a melancholy salt 
marsh, the borders of which are, however, now enlivened 
by neat villages, near Montpellier, has salt waters of 
nearly double the strength of those of Bourbonne, with 
a temperature of n8°. Its waters have obtained a 
somewhat doubtful reputation in paralysis by the active 
application of thermal treatment, including vapour 
baths, douches, and mud impregnated with salt. The 
waters are also drunk. The climate of the place is mild, 
and treatment may very well be carried on in winter. 

Caldas de Montbuy. — These springs, which are only 
four leagues from Barcelona, have a temperature of 153° 
to 1 5 8°, and contain 405 grains of salt in the cubic foot 


of water. They are in great repute for rheumatism, 
sciatica, and old wounds. They have an early season — 
from i st of May to 15 th of July, and after the extreme 
heat is over, from 1st of September to 15 th of October. 

The baths of TriHo f not very far from Madrid, and 
high up the Tagus, are among the most popular spas in 
Spain. The temperature of the water is only from 73 
to 86°, and the amount of common salt or of other 
solid constituents is very small. However, it is lauded 
in rheumatism, paralysis, secondary syphilis, and diseased 
joints. The neighbourhood seems pleasant, and the 
walks are varied. The water is also drunk. 

I can only spare room to name one or two other salt 
baths, the efficacy of which is much aided by the large 
quantity they contain of carbonic acid gas : 

Temp. Carb. acid. C Salt in 16 oz. 

Canstatt . . 70 to 80 19*27 inch. 16*19 gr. 

Soden .. 70 to 80 30 to 48 „ 106 

Cronthal . . 55 to 62 33 „ 28 


Salt Baths strongly impregnated with carbonic acid. — 
This class of baths has come into great favour in 
Germany of late years, and if their advocates at the 
two chief seats of these baths — Nauheim and Rehme — 
are perhaps a little too confident as to the results they 
have produced, there is no doubt that the presence of 
a considerable quantity of carbonic acid in a salt bath, 
while it is most agreeable to the 'feelings, adds materially 
to its efficacy. 


It has been already said, that gases are absorbed by 
the skin with comparative readiness, and it has been 
found that the amount absorbed is proportionate to the 
pressure exercised. In determining the action of the 
carbonic acid present in baths, it is difficult to dis- 
tinguish that of the gas which has been absorbed 
through the skin, from that of the gas which is inhaled 
through the lungs. Braun, while the question remains 
unsettled, thinks it unlikely that, with the capillaries 
of the skin probably strongly contracted by the cold 
water, any considerable amount of carbonic acid can 
be absorbed. 

When a bath of 86°, containing much gas, is taken, 
the reaction and feeling of warmth come on much 
earlier than in a common salt bath. The skin becomes 
red, the action of the muscles appears freer, and there is 
a slight feeling of pleasant excitement in the head. The 
effect on the constitution is believed to be a general 
increase of the activity of the nutrition, and of the 
more important organic functions. 

This form of bath is most applicable as a general 
stimulant and tonic, when the system is low; for in- 
stance in slow recovery from an illness, or retarded 
development of children, and in anaemic cases gene- 
rally. It is used for the same forms of diseases as 
other salt baths. But it has been thought to be 
specially useful in chronic nervous affections, and even 
in some cases of that most hopeless, yet often long- 


protracted malady, tabes dorsalis. The colder tem- 
perature at which these baths are given, renders them 
peculiarly suited to cases of hysterical paralysis and 
other forms of hysteria. These waters can no more 
than those of Kreutznach heal important ovarian or 
uterine diseases ; but they may be of a great deal of 
use in the functional disorders of the uterus, 

Nauheim, with its salt water springs varying from 
about 83 to ioo° in temperature, on the railway between 
Frankfort and Giessen, and distant a pleasant drive from 
Homburg, has of late years come into great notice 
owing to the temperature of its salt water and the 
large quantity of carbonic acid it contains. The great 
Sprudel is the most remarkable well of its kind, throwing 
jets of .water about nine feet into the air, and in this 
respect is only second to Carlsbad, which, owing to 
the quantity of vapour which it emits, is likely always 
to remain the most striking of thermal springs. 

Everything is new at Nauheim, and the arrangements 
of all kinds are excellent, from the handsome conver- 
sation house with its ball-room and gambling-tables, 
down to the bathing-houses and inhalation chambers. 
There are several salt mineral springs, which are, how- 
ever, in taste not at all attractive, after the pleasanter 
similar ones of Kissingen or Homburg. There is a 
great manufacture of salt at Nauheim; so that there 
is no difficulty in making the baths as salt as is de- 
sirable; and there is the air of the gradir Aauser, for 


those who are likely to be benefited by it. The country 
around is fairly interesting. 

Nauheim is for the present chiefly visited by English, 
who go over from Homburg to spend the day there ; 
but it is hoped that, when the gambling-tables are 
closed at Homburg, a portion of the crowd which now 
frequents that place may be diverted to Nauheim : 
and undoubtedly all the best effects of salt baths can 
. be obtained at it. 

Rehme Oeynhausen is well worth the notice of the 
English, both on account of its excellent arrangements, 
and because it is further north than most of the favourite 
watering-places, and therefore the extreme heat of many 
of them is not found there. It lies in Wpstphalia, not 
far from the Porta Westphalica, in a pretty valley, en- 
riched with tolerably high hills, but open to the west, 
with a mild climate, and pure moderately damp air. 
The Cologne and Minden railway passes through 
Oeynhausen, so that it is easy of access. The thermal 
baths are said to be among the finest modern ones, 
and the great cupola inhalation room is the largest of 
the kind. The temperature of the salt spring, which 
rises from a depth of 2,219 feet, is 92 . The baths 
are used in various degrees of concentration. Rehme 
is rising into some importance as a bath; but is chiefly 
frequented by northern Germans; and it is difficult, 
notwithstanding the example of Kreutznach, to expect 
great popularity for it among the English, as the virtues 


of its salt waters reside mainly in the baths, and 
as its salt springs are too strong to be adapted for 

Kissifigen will be spoken of for its drinking waters ; but 
here its salt bath with abundant carbonic acid, which one 
reaches in a short mile's walk, at the salt works, must 
be mentioned. It is cooler than most saline baths, but 
reaction from its first effect takes place very speedily. 
These baths are very refreshing and strengthening. 
They are given in the shape of weUen baths. The 
advocates of Rehme and of Nauheim say, however, 
that baths of this kind should be taken with the water 
still and without moving the body, as the chance of 
absorption of carbonic acid is thereby increased. 

Stronger Salt Waters. — I shall take the first four of 
these, which have all the advantage of being situated 
in the most beautiful Alpine scenery : details need not 
be given of the strength of these baths, which is varied 
according to the requirements of the case. 

IsM, in the Saltzburg district, in the valley of the 
Traun — nearest railway station, Gmunden — is 1,440 feet 
above the sea, and is situated amidst glorious scenery. 
Besides strong salt baths, it offers various attractions to 
the invalid. It has got the character of being soothing 
in lung affections of the erethic type: it has got mud 
baths, two weak sulphur wells, and it is a great place 
for the whey cure. It is often visited by emperors, 
and is a crowded place in the season. There are no 


indications for the use of its baths, in any way special 
to the place. 

Aussee, not far off, in the midst of beautiful scenery, 
presents the same advantages as to salt baths, and is 
quiet and much less expensive. It has also a whey 

Reuhenhall is very similar. It is in the same district, 
and is reached by a branch of the Munich and Saltzburg 
railway. It is in the centre of as beautiful scenery as 
Ischl, and offers the attractions of an inhaling chamber, 
a compressed air apparatus, and of mountain bitters. 
It is only rising into notice; is visited much by the 
northern Germans, little by the English.. It is a quiet 
place, and cheaper than Ischl; close to some of the 
most beautiful scenery, to the Konigsee, the Watzmann, 
and some of those curious channels worked in the 
limestone rocks, called clamms, of which Pfeffers may 
be considered a specimen on a vast scale. 

Kreuth has the advantage of being 3,000 feet above 
the sea; it is reached by a four hours' drive from 
Holzkirchen, passing the beautiful Tegernsee. When 
you arrive there, you find yourself in a meadow of a 
few acres, surrounded by lofty mountains ; and I know 
no more complete picture of the idyllic life the Ger- 
mans are so fond of describing. There are no houses 
here but those connected with the Government baths. 
Besides the salt bath, supplied with water from Reich- 
enhall, there are. two feeble sulphur springs. The 


whey cure is here in full force. It is a very cheap 
and quiet place for those who want a moderately 
Alpine climate, and no very particularly active waters. 
It is frequented chiefly by Germans, and no doubt 
would be voted insufferably dull by English, but 
might be a very pleasant summer residence for quietly 
disposed people, notwithstanding that its arrangements 
are somewhat primitive. 

Bex, in the valley of the Rhone, amidst beautiful 
scenery, but with only the elevation of 1,400 feet, 
possesses a powerful salt spring, which is well worth 
the attention of the numerous English who live here in 
pensions at very moderate rates. It is apt to get very 
hot in summer. Like other places near that end of 
the Lake of Geneva, it is recommended for delicate lungs, 
in the early spring, when it is desirable to leave the 
stations at the head of the lake. 

The old-established chalybeate station of Pyrmont has 
salt springs, used for baths, as well as for drinking. 

So also has Durkheim, in Rhenish Bavaria, a cheap 
place, much resorted to of late years for its whey cures. 

And Rheinfeld, near Basle, promises to be useful in 
the same way. 

Kreutznach, in the valley of the Nahe, less than an 
hour by railway from Bingen on the Rhine, is a pleasant, 
picturesque enough place, with a mild climate, and 
situated very conveniently for those who are not 
German, on the borders of France. Its strong salt 


bath was the first in Europe, which was found efficacious 
in scrofula and strumous swellings, and all the other 
salt springs have come into use, more or less in imita- 
tion of it. 

In this place more scrofulous patients are usually to 
be seen, than at any other source. Scrofula has been 
so long systematically treated here, that the physicians 
have great experience in it The cures attributed to 
iodine, here and elsewhere, are not to be taken for 
granted. The stories one so commonly hears, of fibrous 
and other tumors of the uterus or of its appendages 
being removed by Kreutznach waters, even after courses 
of three or four seasons, must not be too readily believed. 
The salt spring has a material share in the cures. The 
baths are taken about an hour after drinking, and com- 
monly of the temperature of 90 to 92 ; patients usually 
begin with baths lasting for a quarter of an hour, and 
the time is gradually increased up to three-quarters of 
an hour; wet applications and douches are much used. 
The principal wells and baths and the Cursaal are in a 
wooded island in the Nahe, and pleasant excursions 
can be made in the neighbourhood. The arrange- 
ments of the baths, that I saw, rather disappointed 
me, considering the high reputation of the place; 
living is comfortable and not expensive ; there is a 
sufficiency of amusement; there seemed to be many 
English and French present 

The effects of sea-air have already been shortly 


noticed, and those who go to the sea-side to bathe 
are necessarily brought under its influence. Bathing 
in the sea differs from bathing in any other saline 
waters, in the body being in sea-bathing far more 
exposed to the open air and to the presence of waves, 
the force of which produces a certain amount of what 
is called shock to the system. The temperature of 
sea and air, and the effect of the water, must con- 
stantly vary, and the presence or absence of wind 
makes the effect of a bath of this kind much more 
variable than that of a bath taken in a house. 

Sea-water holds in solution on an average in 16 oz. 
of water — common salt, 190 gr., chloride magnesia, 
30 gr., sulphate magnesia, 25 gr., sulphate of lime, 
8 gr., sulphate of potash, 7 gr. ; but the quantity 
varies, being most in the Mediterranean, and least in 
the Baltic. I shall say something afterwards of the 
internal use of sea-water; many attempts have been 
made, especially in England, to have it used in this 
way, but it is nauseous to most people, and is un- 
popular. The sea-water of the Mediterranean may be 
said to have 2\ to 3^ per cent, that of the Atlantic 2J 
to 3 per cent, of salts. The summer temperature of the 
Mediterranean is stated at 72*5° to 8o*6°; that of the 
Bay of Biscay at 73*4°; from it to the British Channel 
68° to 73*4° ; of the German Ocean 60 -8° to 68°. 

The Salter waters are on the whole preferable, but 
the climate of a place is important, and the nearer 


the tejnperature of the sea and air correspond, the 
more suitable is a place for sea-bathing. The Baltic 
is so late in getting heated up, that it is not warm 
enough for bathing till August and September. On the 
English coasts July and August are the great bathing 
months, though many are able to bathe in June. 

As few details can be given here about sea-bathing, 
suffice it to say that, in the case of delicate women 
and of children, it is often well to prepare them for 
open sea-bathing by salt-water baths in the house, 
perhaps beginning with them slightly warmed. Of 
course old people and young children are least able 
to bear cold water or the shock of the waves, and 
many nervous people are afraid of the waves, and 
have to be educated before they can bear their shock. 
It should be so managed, that those who bathe for 
the first time, may not get frightened. It is best not 
to bathe on very wet or stormy days, although some 
make a bravado of never missing their bath. It is 
best to bathe entirely naked, but this can seldom be 
done by men, and is never done by women. The 
English ought to adopt the schwimm hosen of the 
Germans, or the short drawers of Easterns. Women 
very generally use glazed silk caps to protect the hair, 
but this is a great pity, as the immersion and wetting 
of the head is one of the most refreshing parts of the 
process. True, the feeling left in the hair after salt 
water is not pleasant, and sea-bathing causes a good 


deal of the hair to fall out: but the first inconvenience 
can be remedied by washing the hair with lukewarm 
water, and not putting it up till it is dry; and as to 
the last, the hair will soon come in stronger again ot 
itself. The best hour for bathing is between seven 
and nine in the morning; in any case it should be 
got over by twelve o'clock. The bath may vary in 
duration from five to twenty minutes, but long-pro- 
tracted baths are injurious ; one bath a day is quite 
sufficient In a great number of people sea-bathing 
causes a feeling of sleepiness, and in some rare cases 
an eruption. The latter is a contra-indication to its use. 
The general theory of the operation of sea-bathing is 
that of cold bathing with the water in motion, and 
with enough of salt present in it, to stimulate the 
skin slightly. 

Sea-bathing is well adapted for delicate women and 
girls, for men who are over-worked by any kind of 
business and need setting up. It improves the general 
health. It has a very material effect on congestion 
of the uterus, relaxations of its ligaments, and on 
leucorrhcea. It acts as a powerful tonic in irritation 
of the spinal system, but with limitations to be men- 
tioned. It is useful in bracing the system of those 
who are always catching cold ; on the whole, no cases 
benefit so much as those of scrofula, particularly in 
children; now and then children suffering from incon- 
tinence of urine profit by sea-bathing. 


A separate mention must be made of scrofula, the 
disease par excellence benefited by the sea-side. The 
following were found to be the results at the hospital 
for children at Berck-sur-Mer. The mean period of 
residence was nine months, and the cases that gained 
most were found to be, chronic enlargement in all 
degrees of the cervical and submaxillary glands, from 
the most recent swelling without induration, to large 
masses of scrofulous infiltration. These disappeared 
much faster than under ordinary treatment. In scrofulous 
affections of the joints there has often been ameliora- 
tion, but in not so striking a degree. Sea-bathing at 
that place appeared to be contra-indicated in chronic 
inflammations of the eyes or eyelids, in eruptions of 
simple or of impetiginous eczema, which seemed often 
to be aggravated, while strumous and extensive caries 
of the bones remained stationary. 

Much of this is applicable to Margate, the great 
English place for the treatment of scrofula; as its climate 
is more bracing than that of Berck, the constitutional 
improvement there is probably greater. Diseases of 
joints appear to recover in a surprising way, and cases 
can be operated on in that place with success, which 
would scarcely have been ventured on in London 
hospitals. The treatment in the Margate Hospital, 
according to information kindly communicated to me 
by Mr. Thornton, consists mainly in giving good food, 
plenty of good air and sea-bathing, with iron medicinally. 



It is to be regretted that with our vast extent of coasts 
more places have not been utilized for the cure of 
scrofula, like Margate, and that sea-bathing in England 
is rarely carried out on systematic principles. 

Sea-bathing is usually to be avoided where there is a 
tendency to any cutaneous affection ; and if there be any 
eruption present, it should be smeared with pomatum or 
oil before bathing. Except in the form of warm baths, 
sea-bathing is to be avoided in gout and rheumatism. 
It is a doubtful measure, and must be used with much 
care, in convulsive diseases, chorea, and epilepsy; in 
hysteria it is by no means always successful. It is to 
be avoided, when there is disease of the heart or blood- 
vessels or lungs, or any tendency to cerebral congestion. 

But a short space can be spared for glancing at a 
few of the sea-bathing places of Europe. 

The small amount of salt in the waters of the Baltic 
makes its sea-bathing places inferior to those on the 
German Ocean. Much need not be said of the few 
along the latter, as they are seldom visited, except as 
a matter of curiosity, by the English. 

The chief of these are the interesting little sandstone 
island of Heligoland, the resort of the Hamburgers, and 
the small flat island of Norderney, off" the Hanoverian 
coast, where simple quiet living may be had at a very 
moderate rate. Going south, we have the gay and 
crowded Scheveningen at the Hague, fashionable and 
dear, the chief Dutch watering-place. Next comesBlqnktn- 


berg; like the last, situated among the dunes, and offer- 
ing no advantage in the way of natural beauty ; it has 
in a few years grown out of a fishing village into a 
much frequented bath. It supplements Ostend, and 
indeed is in new hotels and other arrangements superior 
to that place, which is perhaps the most crowded sea- 
bathing place in Europe. 

The list of sea-baths as we go along the coast is large, 
and many are resorted to by English. Some of them 
are Dunkirk, Boulogne, Dieppe, FZcamp, Trouville, Biarritz. 
Many of these places are admirably supplied with public 
rooms, baths of hot and cold salt water, swimming-baths, 
&c. A good example of this is the establishment at 
Boulogne; it would be better if we had more such 
establishments in England. With their aid bathing may 
be carried on at all times; without their aid, it is 
necessarily interrupted by bad weather. While Biarritz, 
with a bare country behind it, and no great beauty of its 
own, is crowded to overflowing, it is a pity that no 
English go on to the neighbouring wonderfully pic- 
turesque sea-bathing places of Spain — Deva, Motrico, 
Soutoraran, and San Sebastian, Comfortable lodgings are 
to be had in all, and San Sebastian, which rivals Palermo 
in beauty, has bathing machines ; the whole district is beau- 
tiful, and close to an important group of mineral waters.* 

* San Sebastian has greatly advanced of late, and its capabilities may 
be inferred from the fact that a French and an American company 
are both at this moment anxious to establish gaming-tables there. 

M 2 


We do not hear much of the English making use of 
Italian sea-bathing places ; but the water of the Medi- 
terranean is the saltest of all. Nice, Leghorn, Spezzia, 
Naples, Venice, and Palermo are all bathing-places. 

It would be a long task even to enumerate the English 
sea-side places, which present every variety, from the 
immense scale of Brighton and Scarborough down to 
secluded Welsh villages like Llanstephan and Fishguard. 
As regards health, the main question in selecting one of 
these places is, do you want a bracing climate ? Then the 
east and south-east coast must be chosen. If you want a 
milder, damper climate, go to the west, to Devonshire and 
to Wales. Patients must judge for themselves whether 
they want a quiet, retired, or a bustling place ; at least they 
are pretty sure to follow their own bent in this respect. 

Scotland cannot be considered rich in sea-side resorts, 
as there are few of them where the arrangements are 
good and convenient. On the east coast Portobello is 
best in this respect. I have heard of a German family 
from Hamburg paying it a visit. They found it com- 
fortable, and they thought the expense of it much the 
same as that of a German watering-place would have 
been ; but there was a great lack of amusement, and 
as for a Scottish Sunday, "What did they find it?" 
Nairn, in the north of Scotland, is a flourishing 
watering-place with good arrangements; and some of 
the places down the Clyde are very good, and the 
scenery beautiful; but the climate is too damp. 


Ireland, which is even poorer than Scotland in mineral 
waters, is particularly rich in sea-bathing places. Almost 
all of these are in the neighbourhood of fine cliff 
scenery, and many have excellent hotels. For instance, 
one of the most comfortable of all is Portrush, near 
the Giant's Causeway. Going along the coast towards 
the south, you come to the secluded Cushindall, and to 
Glenarm. Next comes one of the newest and most 
popular, Newcastle; then Ross Trevor and Warren- 
J>ointy as lovely as can be. Passing Dublin, you reach 
Bray, more in the style of a new English watering-place, 
with its sea views, reminding you on a fine day of the 
coast of Italy ; in the west, Kilkee and Bundoran, both 
open to the full sweep of the Atlantic, the one half- 
embayed, with lofty rocky scenery in its neighbourhood, 
the other commanding gloriously wide sea views : but 
the field for the choice of such places in Ireland is 

In the present state of our knowledge, the efficacy 
of most of our alkaline and saline baths, those contain- 
ing carbonate of soda, sulphate of soda or of potash, 
or iron salts, must be considered to depend mainly 
on the general properties of water, and in some instances 
on the quantity of carbonic acid they contain. It has 
been already seen that many of the weaker salt waters, 
such as Soden, Cronthal, Homburg, Canstatt, contain 
considerable quantities of carbonic acid, so also do 
various thermal alkalo-saline springs, such as Vichy, 


Ems, Neuenahr, Carlsbad; or cold ones, as Franzensbad, 
Marienbad, Elster, Tarasp; or iron baths, as Schwal- 
bach y Rippoldsau, Petcrsthal, Pyrmont, St Moritz. 

It has been pointed out very fully by Dr. Braun, that 
the quantity of carbonic acid likely to be present in a 
bath, depends upon a variety of circumstances ; such as 
whether the temperature of the water has to be raised 
for the bath, or again, whether the water of the spring 
has to be allowed to cool down first. In either case 
a great deal of carbonic acid is lost ; much will, however, 
depend on the arrangements used in preparing the bath. 

As none of the mineral contents are absorbed in the 
case of alkaline and alkaline saline* waters, the effect 
is that of very soft water, which mollifies the epidermis, 
and makes it particularly easy to clean the surface of the 
skin. No such waters are rich enough in salts to act as 
stimulants, and the stimulating action of such baths 
depends on their temperature and on the carbonic acid 
they contain, unless the bath is made strong artificially, 
which is expensive. 

Much the same is the case with steel baths, in which 
ladies have so much faith, not entertaining a doubt that 
the iron is absolutely absorbed through the pores of the 
skin. This is entirely imaginary; not so, however, the 
benefit which they actually derive. 

Flechsig, after a careful analysis of the comparative 
effects of lukewarm water, of plain water, and of water 
containing iron and carbonic acid, has arrived at the 


following general conclusion, that iron baths act on the 
system mainly by producing stimulation of the peri- 
pheral nervous system, and thus altering the functions 
of the skin and lungs. The altered activity of the skin 
seems to be the prime mover of the further changes 
which take place in the interstitial change of tissue. 

Along with increased appetite, which they have the 
power of giving in common with plain water baths, 
they seem really to support the powers of assimilation 
in a greater degree. 



There is no occasion to discuss here the infinite variety 
of these, general and local, that have been popular at 
various times; for instance, those of horse dung, or those 
of malt, in which cases there is generation of carbonic 
gas, or such things even as baths of blood and baths of 
tripe ; but I have to notice some of the forms of such 
baths, which form a part of bath or other popular 
methods of cure. 

Arenatioriy or covering the body with the sand of the 
sea-shore, is a very old practice,* and has been recom- 
mended of late years by various French and German 
writers, and at various sea-bathing stations, such as 
Blankenberg and the island of Norderney. The patient 
lies in a hollow excavated in the sand, and has a layer 

* The buccaneers used to bury themselves in the sand for the cure 
of fevers. "Dr. Graham," as is well known, "exhibited himself 
towards the close of the last century buried in earth, with only his 
head, duly powdered, and pigtail above the ground, and beside him 
also buried his goddess of health, the future Lady Hamilton." — See 
a well-written article in the British and Foreign Medical RevUw 
for April 1857. 


of damp sand thrown over him. He is exposed to the 
full rays of the sun. The process is said to cause free 
sudation, and to stimulate the skin. The exposure to the 
sun, however, appears to be a very doubtful measure. 

This process is a very favourite one on the shores of the 
Mediterranean, and the following is an account of it as 
practised in Ischia, and best at St. Restituta in that 
island. The sand there is heated by the percolation of 
mineral waters and hot air from below. Fresh grave-like 
holes are dug in the sand, in which the patient lies down 
at full length, and is covered up to the neck with a depth of 
eight to ten inches of sand, the heat of which is about 108 
to 109 . Weaker patients remain in this about a quarter 
of an hour, stronger ones half, or at most three-quarters of 
an hour. The deeper the hole is dug, the greater is the 
heat; besides profuse sweating, stimulation of the skin, 
amounting even to blistering, may be produced, if the 
process is kept up too long. This process, usually 
carried on in the open air, is not a favourite with any 
but the natives of the country. After the arenation is 
over, the patients sometimes bathe and wash themselves 
in the mineral water; others again roll themselves up 
in sheets till they are dry, thinking that rubbing off the 
sand will interfere with the efficacy of the bath. 

From very early times the scum or the deposit of 
baths has been collected, and used under the very 
natural idea, that it contains in a concentrated form the 
principles on which the efficacy of the bath depends. 


In this way, the mother water, as it is called, of brine 
springs has been used; ochry deposits from chaly- 
beates, and sulphur from sulphur waters, as well as 
the half animal, half vegetable substances which grow 
in waters, such as those of Bareges and Gastein, and 
many other thermal springs, have all been employed. 

We have seen how the mud has been made use of at 
Acqui, Abano, St. Amand, and other places. 

The operation of all these baths is evidently the 
result of the action of thermal waters intensified, and 
accordingly their chief application has been to old 
rheumatic and gouty affections, contraction and enlarge- 
ment of joints, chronic glandular enlargements and 

But of all baths of this description, one, which it 
would be easy to introduce into this country, is by far the 
most popular; it is one the virtues of which are freely 
admitted alike by bath physicians, who are sceptical 
about the powers of mineral waters, and by those who 
•have most confidence in them ; I mean peat baths. 

Moor, turf, or peat baths are now supplied in most 
German spas. They consist of peat earth, which has 
been exposed to the action of the weather during winter, 
and has been thoroughly impregnated with the particular 
mineral water of the place. It is finely powdered and 
prepared to a consistency of thick soup or broth. The 
average temperature of these baths may be considered 
95 . Uninviting though the mess looks," and though at 


first one is unwilling to be immersed in this oozy, dirty- 
looking bath, when you have once got in and allowed 
the slimy broth lazily to cover you, a very pleasant 
velvety sensation is imparted to the whole surface. On 
taking one of these baths, one is able to appreciate in 
some degree the practical philosophy of the pig, who 
wallows in the mire in a hot sun. He has shown him- 
self a good judge of what is pleasant to the feelings. 

As to their physiological effect on the system, peat 
baths are more exciting than might be expected from 
their temperature, and even a local one will often cover 
the whole person of the patient with perspiration. These 
baths bring out eruptions more readily than mineral 
waters, and indeed if carelessly used they cause a 
good deal of irritation of the skin. They are con- 
sidered to increase the activity of all the functions of 
the skin, to quicken the circulation and the renewal of 
tissue, and to stimulate the secretory organs and the 
nervous system. 

How all these effects are produced, that is, through 
what power besides their thermality, is quite undeter- 
mined. We have already seen that similar effects are 
produced by the mud of various baths ; the peat earth 
and mineral impregnation of each bath varies somewhat, 
and the richness of the compost of each bath is praised 
up by its advocates ; yet they all seem to produce the 
same effect. 

Although we know, that salts are less likely to be 


absorbed from such a mess than from water, still the 
chemical composition of these baths has often been 
examined with a view to explaining their effects. A 
hundred parts of the peat earth of Teplitz dried,, yielded 
5 5* 1 6 parts of inorganic matter, 4484 of organic 
substances and water chemically united with them. 
Among insoluble matters are found humic acid, vegetable 
remains, minute quantities of lime and silex, and in some 
baths a considerable quantity of oxide of iron. The 
soluble matters are comparatively few and in small quan- 
tities, as sulphate of potass, magnesia, soda, iron, silicic 
acid. Peat baths generally have an acid reaction. A 
chemist has recently extracted from the peat bath of 
Franzensbad, what he considers to be a compound salt, 
of sulphate and oxide of iron; sulphates of soda, 
magnesia, and lime; silicic, humic, and phosphoric 
acids, besides free sulphuric acid. 

The one of these substances to which most has been 
attributed is iron, and we hear gravely of the styptic 
effects of some of these baths; but there is not the 
slightest reason to suppose that the baths containing 
most iron are more efficacious than the others. Inquirers 
into the subject of their efficacy have thought of the 
possible action of carbonic or other gases which are 
developed, of special organic matters, such as formic 
acid, which has sometimes been detected ; but there 
is no satisfactory explanation, if turf baths are superior 
to other thermal applications, why they are so. 


Peat baths are either taken before or after ordinary 
baths, or they are used alternately with mineral baths, 
so that one day a common bath, next day a peat bath is 
taken. Local peat baths and poultices are in great 
favour, and are often used for thirty minutes and longer ; 
half peat baths, in which the body is covered up to the 
stomach, are seldom borne more than twenty minutes. 

A mass of clinical observation seems to make it 
certain, that this general poultice applied to the whole 
surface, is of much use in the same cases as thermal 
baths. While less exciting than thermal waters of the 
same temperature, they seem to have more of a resol- 
vent power in exudations and thickenings of the joints; 
but indeed the variety of affections in which they are 
considered especially applicable is very great. I shall 
only mention anaemic conditions, congestion of liver and 
spleen, spinal irritation, especially of an hysterical nature. 

These baths, which are growing daily in popularity, 
are contra-indicated in patients inclined to congestions 
of the head, with disease of the heart, or tendency to 
phthisis, or where eruptions are present. 

Peat water. — Baths of the common dark coloured 
water impregnated with peat, so common in all our 
moors, have of late been used ; but what their special 
virtues are, I have not heard. 

Baths of Pine Balsam. — At many baths where pine 
woods are abundant, there has been got by distillation 
from the fresh green leaflets of the pines, a pretty clear 


greenish-brown fluid, of strong, pleasant aromatic odour, 
which, along with various resinous substances, contains 
an ethereal oil and a little formic acid. This balsam is 
added in various proportions to baths, to make them 
stimulating to the skin. For children and excitable 
people one to three quarts are added. The quantity is 
gradually increased every day up to fifteen or ten quarts, 
and full-grown people may use double these quantities. 
The temperature of these baths varies from 8o° to ioo°. 
Their operation produces itching and pricking of the 
skin, and its general stimulation. They are found useful 
in chronic rheumatism, and in some neuralgias, and 
when a general stimulus to the surface is wanted. The 
balsam is also used still more effectively in the shape of 
vapour baths. This remedy, though greatly over-praised 
some years ago, is a useful one, and ought always to be 

Baths of the fermenting dregs of the wine tub 
have also been used in districts where grapes are 
abundant ; there is a great extrication of carbonic acid, 
and they act powerfully on the skin, but are not often 

Baths of Whey. — At certain whey cures, and other 
places where milk is abundant, baths of this fluid, of 
which, as a drink, something will be said afterwards, 
have been employed in great irritability of the nervous 
system, in neuralgias and over-irritability of the skin, 
and they are as efficient as baths of other bland fluids. 


Baths of milk, an expensive remedy, have been used 
chiefly as a cosmetic by voluptuous women, and some- 
times, in cases of great debility, in the hopes of a 
portion of it being absorbed where food could not be 
swallowed, but such uses do not come within the scope 
of this book. 

The operation of vapour baths has been already 
discussed; it remains to notice the applications of 
various gases to the surface of the body, at least of 
such as are employed at bathing-places. 

Advantage was very early taken of escapes of gas 
from rocks in volcanic countries, and they were employed 
for the production of natural gas baths. Baths of this 
kind are to be found at San Germano, Castiglione^ the 
Solfatara, and other places in Italy, and at Cransac 
in France. The gases are carbonic acid, hydrosul- 
phuric acid, and exceptionally, at the Solfatara, ammo- 
niacal gas. 

Of late years, wherever carbonic acid or hydro- 
sulphuric acid are abundant in mineral waters, arrange- 
ments have been made for their use in baths, and 
carbonic acid baths have been much lauded. In some 
instances a stream of this gas is let into the bottom of 
an ordinary bath. But besides its employment in this 
way, the gas is collected from the mineral waters by a 
simple process, and by means of tubes is easily dis- 
tributed for use as wanted. A patient going to take a 
bath of this gas, seats himself with most of his clothes on 


in a sort of box, in which his whole person is enclosed, 
except his head and neck. The gas is let in from below, 
and gradually rises and displaces the atmospheric air. 
The gas produces, after a time, a pleasant tingling 
sensation, and a certain feeling of heat accompanied 
with perspiration: it is said to quicken the pulse and 
act on the generative organs. A bath usually lasts for 
ten or twenty minutes, but it must be discontinued the 
moment sleepiness, swimming of the head, or any other 
unpleasant symptom comes on. These baths have 
been used in paralysis and loss of power, also in some 
rheumatic affections; but their virtue, if any, is very 

This gas is also used locally in douches ; it has been 
applied to the eyelids closed, when it produces a certain 
amount of tingling and burning ; it has also been applied 
to the external ear-passages, but practitioners seldom 
place any real faith in such applications, which at first 
have a stimulating, but afterwards a deadening effect on 
the function of these organs. 

Carbonic acid is also sometimes applied to relieve 
painful affections t of the uterus, and as a local stimulus 
to it, but the gas is very readily absorbed from mucous 
surfaces, and the practice is not unattended with danger. 
The baths of this gas appeared to me to be little used 
in most establishments. 

Hydrosulphuric acid is also at some baths collected 
from the waters impregnated with it, and is occasionally 


used in douches ; even if not inhaled, the gas, if applied 
pure to the surface of the whole body, would have almost 
poisonous effects, and the gas has to be much diluted, 
before it is applied to it. Of the effects of its applica- 
tion in this way in baths very little is known, but they 
are supposed to be analogous to those of carbonic gas. 

Sulphurous acid occurs as an emanation from vol- 
canoes, but as such has not been locally applied. 
Sulphur fumigations locally applied cause heat, slight 
tingling and redness of the skin, and free perspiration, 
to which no doubt the heat necessary for the vaporisation 
of the sulphur contributes. They are a very old remedy 
in rheumatism, fever, and itch, and in epidemics to 
this day they are counted the best gaseous disinfectant 
There has been quite a furore of late in Scotland about 
their use, but I believe it has nearly died out. 

Chlorine. — Minute quantities of muriatic acid occur in 
volcanic and in sea air, and also in the air about the 
gradir haiiser ; but in the only local application of 
chlorine gas which is used, it is combined with the 
vapour of water. It is a strong stimulant to the skin, 
and after a time produces constitutional effects, in- 
cluding a certain amount of salivation; it is believed 
to act powerfully on the biliary organs, and it is no 
doubt to the presence of this gas that the nitromuriatic 
acid bath owes its efficacy, for as an acid solution can 
only act as a stimulant to the skin, the nitromuriatic 
acid does not enter the system, and its efficacy, which 



has never been thought highly of abroad, must depend 
on the action of the chlorine which it contains. 
. To this list may be added vapour baths impregnated 
with the odour of certain aromatic herbs, an addition 
popular at some places. 

In judging of the effects of gases used as baths, it 
must be remembered that, with the exception of car- 
bonic acid, all the other gases are applied associated 
with the vapour of water. In many of these cases, 
unless special precautions are taken, and indeed in the 
uses of all mineral waters containing much gas r the 
inhalation of a certain amount of the gases is neces- 
sarily associated with their external employment. 

Electrical Baths. — It has already been said, that 
electricity is an extremely useful aid in the thermal 
treatment of paralysis; nay, some are confident that 
it helps in the resolution of tumours. It was also 
observed that one explanation of the action of mineral 
waters was based on their electrical action. For instance, 
Schonbein considered that he had demonstrated that 
positive electricity is developed in some maladies, as 
the acute exanthemata, and negative in rheumatism. 
Rheumatism is cured by Baden waters ; they have been 
shown to be positively electrical. It is thence inferred, 
that the cure is caused by electrical action, although, 
granting the facts, the theory of the cure is not very 
obvious. But all the common actions of life, the very 
friction of clothes on our persons, the passing a comb 


through the hair, the pouring water from one vessel into 
another, develop electricity, not to mention its genera- 
tion by the vaporisation or pulverisation of water. 

It is impossible to accept many statements respecting 
the electrical effects of mineral waters ; we are told that 
after using the Carlsbad waters for some time, ladies 
find their hair, when let down, stand apart. This lady 
feels an electric shock, when she gets into a mud bath ; 
that gentleman feels one, when he plunges into the sea. 
But this subject is alluded to here at all, because 
electro-galvanic baths are often connected with sea and 
other bathing establishments, and the galvanizing a 
patient in water baths between the poles of a battery 
has become a very popular practice. The negative 
electrode is put in connexion with the metallic side 
of the bath, and the positive is put into the hands of the 
bather. The water is acidulated sufficiently with nitric 
or hydrochloric acid to make it stimulating to the 
skin. While the legitimate application of electricity in 
medicine is being studied and gradually developed, 
such applications as galvanic baths are chiefly meant 
to tickle the fancy of the public, and have fallen very 
much into the hands of charlatans. 

A portion of treatment, to which much importance 
is attached at many baths, is the inhalation of the 
vapours and gases of the waters, a subject which may 
be conveniently noticed here ; and first of the vapours 
of common salt. 

N 2 


They are inhaled cold, by patients who are made 
to walk along and in the neighbourhood of the giant 
fences of fagots, through which the water of the salt 
springs is made to trickle for purposes of concentra- 
tion; patients are directed to choose the side of the 
hedges {gradir hauser) protected from the wind, as 
there the air is richest in saline matter; they are also 
directed in fine weather to rest on seats in their 
neighbourhood. It is calculated that 7 or 8 grs. of 
salt are inhaled per hour. It seems very problematical 
whether, in the inhalation of such air, there is any gain 
beyond what results from a comparatively cool, moist 
atmosphere in hot weather. Such unsightly fences are 
to be found at Kreutznach, Kissingen, Nauheim, Reichen- 
hall, and elsewhere. 

Saline air is also presented by a process of pulverisa- 
tion in inhaling-chambers at many of the salt springs ; 
it has been calculated that 10 grs. of salt are inhaled 
per hour by this process; and the warm vapour may 
be inhaled by various arrangements, as it rises from the 
heated salt-pans. These inhalations are found to be 
useful in chronic catarrhs of the mucous membrane of 
the air-passages, and in bronchitis. 

Chlorine. — As infinitesimal quantities of this gas, 
probably in the form of hydrochloric acid, are present 
in sea-air and in the vapour of salt-pans, it has been 
supposed that its vapours might be found useful, and 
at many baths the inhalation of chlorine gas, mixed 


with atmospheric air, has been tried, but the results 
have not been satisfactory. 

Sulphur. — The vapours of this substance have been 
a favourite remedy from the earliest times. Galen sent 
patients to Sicily to inhale the sulphur fumes of Mount 
^Etna, and lately, in Scotland, not only serious chest 
affections, but rheumatism and neuralgias have been 
cured by it, could one accord full credit to the state- 
ments. However, it is in the form of hydrosulphuric 
acid that it chiefly occurs in mineral waters, and there 
is not now one of the numerous sulphur baths, hot or 
cold, in which inhalation does not form a portion of 
the cure ; a popular handbook says, " Hydrosulphuric 
acid tones down the action of the nerves, retards the 
circulation, favours excretion, and by its continued 
action produces a general perspiration." It must be 
used with care, and where there is irritation of the 
lungs or cough, it must be slowly and quietly inhaled, 
as otherwise it is apt to cause congestion of the lungs ; 
for purposes of inhalation the atmosphere of large rooms 
is impregnated with it, and usually along with some 
nitrogen and carburetted hydrogen gas, the first of which 
predominates in the Pyrenean, the latter in the German 
baths. Such inhalations are considered in Germany, and 
still more in France, to be very useful in pulmonary 
cases. Of the absolute effect of the inhalation of 
hydrosulphuric acid in any but large and poisonous 
doses, very little is known; as nitrogen to a certain 


degree takes the place of oxygen in these waters, the 
air inhaled may be thus less exciting, and therefore 
more soothing. 

But, after all, the effect of these inhalations is perhaps 
more negative than positive, and the importance of the 
inhalation of aqueous vapour along with the gas must 
not be forgotten. 

Carbonic add is exciting when present in the blood 
in small quantity, paralysing when in large : at some 
baths it is necessary to take precautions against its 
excessive accumulation in the bottom of chambers. 
The gas cannot be inhaled pure, and is used only in the 
proportion of two to four per cent, of atmospheric air ; 
it is inhaled in cabinets, into which the gas is made to 
flow from below. To make the gas less exciting some 
moisture is added to the air. The effects are said 
to be, quickening of the respiration; the expiration is 
more complete; there is acceleration of the pulse, and 
a feeling of warmth in the chest; lessening of 
secretion into the bronchia^, and dryness of the throat ; 
then perspiration breaks out, and there is swimming in 
the head, and the process must be stopped The gas 
is said to improve the secretions of the air-passages and 
to quicken the activity of the lungs, but all this is, to 
say the very least, problematical, and in most places, as 
already observed, the carbonic acid cabinets seem to me 
to be deservedly falling into neglect. 

Oxygen. — Although more or less of this gas is present 


n drinking and in many mineral waters, Kttle is known 
of the effects of any inhalation of the gas derived from 
natural sources, and nothing heed be said here of its 
artificial preparation and exhibition. 

Nitrogen. — This gas is present in considerable quan- 
tities in the waters of Lippspringe, Teplitz, and many 
of the Pyrenean and Spanish baths, and its inhalation 
is supposed to be useful in pulmonary complaints. If 
it be really of any use, it is probably by diluting the 
air, and thus letting a smaller quantity of oxygen, which 
is somewhat of an irritative, enter the lungs. 

Carburetted Hydrogen. — Of the effects of the inhalation 
of the small quantities of this gas which are sometimes 
associated with other more abundant gases of mineral 
waters, nothing positive is known. This gas, which has 
much analogy with naphtha, a favourite remedy in the 
East in cutaneous disorders, appears to be more abundant 
in the waters of La Porretta than of any other place. 

Vapours of balsam of fir. — Even in ancient times 
patients were recommended to inhale the air of pine 
forests, and at the present day the neighbourhood of 
fir woods is considered to be one of the great advan- 
tages of places for consumptive patients; for instance, 
Bournemouth and Arcachon. The use of a bath 
with fir balsam led very naturally to the inhalation of 
that substance, as it is practised at Ischl, Reichenhall, 
and other places; and there is no reason to doubt, as 
balsams have always been employed for such purposes, 


that moist air impregnated with fir balsam may prove 
useful in bronchitic affections, and tend to allay irrita- 
tion in them; indeed, in close analogy with this are 
the medicinal inhalations of air impregnated with tur- 
pentine, creasote, or carbolic acid. 

The great argument against the special value of any 
one of the inhalations we have alluded to, is that their 
fashion changes constantly — for a few years or months 
this substance is the favourite, in a few another takes 
its place. An enthusiastic practitioner, probably a young 
man, convinces himself that he has hit on a new remedy 
of extraordinary efficacy; or a less scrupulous one, or 
a quack, satisfies himself that he has discovered what 
will at least take the fancy of the public for a time, and 
that is all he cares about. In all these varied inhalations, 
the only element which remains constant is a certain 
amount of warm aqueous vapour, which never fails to 
be soothing in bronchitic and laryngeal affections.* 

* Since this was written, I have seen an amusing brochure attri- 
buted to Dr. De Hartsen of Cannes, giving an account of the 
delights of the winter station of Doux-Repos. He tells us how 
successful Dr. Anglicide has been in utilizing for the benefit of the 
poitrinaires, by'means of pulverising and inhaling apparatuses, one of 
the natural products of the place, its fine calcareous dust. He ex- 
plains fiow the very disadvantages of a place may be converted into 
its recommendations ; how in his winter station the bise is adapted 
for the lymphatic form of phthisis, the southern wind for dry 
coughs, and how the patient is to remain at home or go out, accord- 
ing as the wind suited to his condition blows or not. He tells many 
unpleasant truths, for instance of the doctors often playing into the 
hands of the lodging-house keepers. 





What has already been said about drinking water will 
have prepared us for considering that fluid to be a thera- 
peutic agent of importance ; however, it is apt to be used 
in far too large quantities, and when the stomach is over- 
loaded, its curative effect is lost or greatly diminished. 
People have drunk enormous quantities of both cold and 
thermal waters. At Contrexeville there are patients who 
steadily drink from thirteen to twenty-two pints. At 
Pougues, a man has been seen to drink ten pints at 
once. A peasant, aged eighty-two, used to come for 
many years to Euzet for three days, and drink the first 
day 50, the second 100, and the third 150 glasses of 
the sulphur water, the maximum being at least sixteen 
or eighteen quarts. The following are examples of the 
way in which the warm indifferent waters are sometimes 


Panticosa. — The water here is without taste or smell, 
with only slight traces of sulphate and carbonate of lime. 
The ease with which the stomach bears it is quite 
marvellous. C. James says, " I have drunk eight glasses 
of it in an hour without having the least feeling of heavi- 
ness or of satiety." The patients usually drink from 
twenty-five to thirty glasses a day. It is sedative, and 
produces no febrile reaction. It is prescribed with 
success in bronchial catarrhs and in incipient phthisis. 

Eaux Bonnes. — Its waters contain a minute quantity 
of sulphuret of sodium, a very little silex, and rather 
more sulphate of lime. The extreme activity of these 
waters makes it necessary to commence their use 
with great care. One begins with half a glass, gradually 
increasing to four or five daily. But there are some 
patients so impressionable that they can only bear them 
in spoonfuls. Scarcely has the water reached their lips, 
before they already feel the most of its effects. There- 
fore no one now will follow the advice of Bordeu, who 
made his patients drink five or six pints of the water 
every day, and even advised its use at the dinner-table. 
At the present day, says James, patients who can use 
the waters in such a way, are rare. Generally they excite 
so much reaction that they have to be discontinued. 

The waters both of Panticosa and of Eaux Bonnes con- 
tain but a very small amount of sulphuretted hydrogen. 

Something has already been said of the situation of 
Panticosa. Eaux Bonnes, like its neighbour, Eaux 


Chaudes, is reached from Pau. It lies in a narrow gorge, 
and has been greatly improved of late years. The 
climate is mild, but the alternations of temperature make 
it necessary for patients to be warmly clad here as in all 
the Pyrenean baths. It has become a great place of 
resort in consumption, mainly for cases of atonic phthisis, 
also in clergyman's sore throat, and laryngeal affections. 

Plombieres. — Its waters are, perhaps, less mineralized 
than any others. Patients begin with one or two glasses, 
and increase them to five or six ; in former times they 
used to take from fifteen to twenty. The water is easily 
borne by the stomach, and never produces crises or 
disagreeable effects. It is greatly valued in chronic 
catarrhs of the stomach, and I have little doubt is really 
useful. These waters, and the feebly mineralized ones 
of Teplitz, are not, however, found to be of any use in 
phthisis, like the others just mentioned. 

The preceding examples are instances of the internal 
use of indifferent waters, and most of them have been 
drunk warm. How much are we to attribute to imagi- 
nation, and how much to the simple effect of warm 
water ? Something to both, but most to the latter. 

Similar instances of the use of indifferent cold waters 
might easily be multiplied. The vast majority of sulphur 
or of chalybeate springs for example in England are so 
slightly impregnated with any mineral contents, that 
the cures effected by them must be regarded simply as 
cold water drinking cures. In former days far more 


faith was placed in those feeble wells; now most of 
them have been forgotten. They, however, continue to 
supply the same water as formerly. The secret of their 
usefulness was, no doubt, contained in the early morn- 
ing walk and the copious draughts of fresh water, which 
were forced on those who resorted to them. The fol- 
lowing list of waters, which at one time or other have 
been drunk, shows how little they can have owed to 
their few grains of mineral constituents in the pint : — 
Gastein, 2*6 ; PfefTers, 2*29 ; Wildbad, 4*3 ; Plombieres, 
172 ; Schlangenbad, 2*5; Teplitz, 8*4; Buxton, 2*2. 

The earthy salts are sulphate and carbonate of lime, 
carbonate of magnesia, and sulphate of alumina. Of 
these the two first play far the most important part in 
mineral waters. An immense quantity of lime is required 
by the system, and is supplied to it in food chiefly in 
the form of phosphates. Lime taken into the stomach, 
and that is made use of, deposits itself in the system 
mainly in that form, in which also it is chiefly excreted 
through the alimentary canal. Of the physiological 
effects of carbonate or of sulphate of lime, little is 
known directly. They act to a certain degree in 
neutralizing the acids of the intestinal canal; but in 
large quantities, especially in the form of the sulphate, 
they retard digestion, and in very large quantities may 
be injurious, although the old notion that gypsum (the 
sulphate) was a poison, is untenable. We may probably 
expect from their use some diminution of excessive 


secretions and of over-action of the kidneys. A still 
larger quantity of magnesia than of lime reaches the 
stomach in the food, but of its use in the economy 
our knowledge is imperfect. The greater part of the 
magnesia leaves the system unaltered, not being required 
by it The carbonate, besides neutralizing the acid of 
the stomach, acts slightly as an aperient 

With the effects of alumina we are but partially 
acquainted. It acts chemically on surfaces to which 
it is applied, and which are not protected by mucus, 
and it undoubtedly is astringent, and is inclined to 
produce constipation. 

Of earthy waters by far the largest constituent is lime. 
•The amount of carbonate of magnesia present in them 
is small, and alumina is generally presented in some 
shape, which makes it very disagreeable to swallow it 

Earthy salt waters are much more used as baths than 
for drinking. But springs with lime in them have often 
been in repute in the treatment of diseases, such as 
osteomalacia, in which it was supposed that the system 
suffered from a defective supply of lime ; but abundance 
of lime is always offered in food ; the defective action is 
with the system. You cannot make it take up lime by 
simply presenting to it that substance, even in the state 
of phosphate, however theoretically correct such practice 
may appear to be. The root of the disease lies either in 
the stomach not being able to take up lime, or in the 
organs excreting too much of that substance, and it is to 



correct such state of the system that we must address 
ourselves. Phosphate of lime, I believe, like many other 
medicines, owes its reputation mainly to the fact of its 
being innocuous. 

For somewhat similar reasons the lime waters have 
gained some credit in scrofula and in tuberculosis ; 
probably on equally insufficient grounds. 

They have often been used in dyspepsia, a complaint 
in which, when used with moderation, they may be of 
benefit as antacids, and, indeed, it is only in this last 
way that we can imagine their being of use in the con- 
stitutional affections just enumerated. 

The" rationale of some of these weak lime waters 
being esteemed as efficacious as the distinctly alkaline 
waters in bladder affections is not quite clear ; but some 
of these waters have a reputation in gravel and affections 
of the bladder, which is founded on experience of their 
real utility, which cannot be easily gainsaid. 

Many of the earthy springs that have been already 
described as being chiefly used for bathing, are also used 
for drinking, such as Leuk, Lucca, Sacedon, Bath. The 
following table gives a notion of the amount of lime 
which some of them contain : — 

Total Mineral 

Carbonate of 

Sulphate of 





. . 14*3° • • 

. IO'6° . . 

• ' 


. . 7*8 . . 

1*3 • • 

• 37° 

Lucca . 

. . 15* • • 

• "' "* • • 

. 6*9 to 13*8 

Bath . 

■ • 155 • - 

• ^~" • • 

. 8-4 


Many of the earthy wells contain iron, and are described 
as chalybeates, while others, such as Baden in Switzer- 
land, have been mentioned already as sulphur baths, so 
that the list of earthy wells employed for drinking, to be 
run over, will not be large. 

Lippspringe, in Westphalia, has of late years risen 
into great reputation in affections of the chest, not- 
withstanding its northern position, and that its climate 
is rather damp and not particularly mild, though tolerably 

The chief well contains about 10 grs. in the 16 ozs. 
of lime and insoluble salts, and a very large quantity of 
carbonic and of nitrogen gases. One to three glasses of 
the water are drunk in the morning, and if necessary one 
or two in the afternoon. Baths are used as an auxiliary, 
and also inhalations of nitrogen. There are comfortable 
arrangements for visitors, and walks in the park. A 
few miles off are the baths of Paderborn, which are 
still richer in nitrogen, and also used for inhalation. 
Cases of consumption in their early stage are said to 
benefit much by the use of tepid baths, inhalations, 
and the drinking of these weak lime waters. 

Wildungen, in the little state of Waldeck, in a fruitful 
valley, is one of the baths that can still boast of a 
gaming-table. It has several wells, the two chief of 
which contain about 10 and 20 grs. respectively of car- 
bonates of lime and of magnesia in the 16 ozs., besides 
other salts in smaller quantity, also a large quantity of 


carbonic acid gas. These wells have a special reputation 
in affections of the bladder. The water must be drunk 
for five or six weeks, and its internal employment is 
supported by the use of baths. 

The arrangements for visitors are good. 

Fured, a most popular Hungarian bath, much visited 
from Vienna, is situated beautifully on the slightly saline 
lake of the Platten See; its waters contain about 7-5 grains 
of carbonate of lime and other carbonates, and about 6 of 
sulphate of soda, with as much as 38 inches of carbonic 
gas ; it is, therefore, difficult to say whether it should be 
classed among earthy, saline, or acidulous waters. Two 
wells are used for drinking and one for bathing. Small 
doses only are drunk. The baths are said to be very 
pleasant from the quantity of gas they contain. There 
is also bathing in the lake, and abundance of amusement 
of every kind. 

These waters may be considered useful in cases where 
stimulation of the skin by carbonic acid is desired, and 
where acidulous waters with slight purgative effect are 
indicated, as in many cases of dyspepsia with torpor of 
the bowels. The season begins in May and ends in 

Weissenburg, in a ravine off" the Simmenthal, not very 
far from Thun, has a well which contains about 20 grs. 
of lime in the 16 ozs. and which has a great reputation in 
cases of chronic bronchial catarrh, and some eminent 
Swiss physicians have much confidence in its efficacy in 


such cases. The temperature of the spring is from 75 to 
8o°. Meyer-Ahrens tells us that new arrangements have 
made a perfect little paradise of this place, but it is 
gloomy and cut off from the world, and is therefore 
only suited for those of very quiet tastes, and there is 
nothing in the composition of the waters to inspire us 
with confidence in them. The waters are chiefly drunk. 
There is little bathing. The height is 2,759 feet 

Courmayeur is little visited by the English, but much 
resorted to by Italians during the season. It has a 
great deal in its elevated situation and in the beauty 
of its scenery to attract visitors. Its waters contain 
8 or 10 grs." of carbonate of lime and of magnesia, with 
small quantities of sulphate of soda and of magnesia. 
They are slightly purgative. They enjoy a reputation 
in bronchial affections, in struma, in some affections of 
the bladder and of the skin. 

Ckianciano, to which the nearest town of importance is 
Sienna, lies in the valley of Chiana, at a height of over 
1,800 feet, not far from Monte Pulciano, famed for its 
wine ; it has springs of the temperature of ioo°, strongly 
impregnated with lime, one of these having about 
twenty-five grains, in the sixteen ounces, of insoluble 

These wells have a great local name, and as much 
as twelve pounds of one of the springs used to be 
drunk daily by the patients. Like other lime waters, 
they have reputation in irritation of the bladder and in 



gravel, also in indigestion ; used in the form of baths 
and of douches (and the Italians have always been 
particularly fond of douching), they have been found 
useful in enlargements of the liver and spleen, and as 
injections in vaginal catarrhs. They are chiefly resorted 
to by Italians, the accommodation seeming to be rather 
poor ; but the charges are not high, and there are many 
interesting Etruscan remains near. 

Contrexeville, in the Vosges, situated in a narrow 
valley about 1,000 feet above the sea, used to be rather 
a dull place of resort, but has considerably improved of 
late years. It owes its reputation to its cold lime waters, 
which contain about sixteen grains in the pint of salts of 
lime and magnesia, and minute quantities of carbonate 
of soda and other salts. 

These waters are used chiefly in affections of the 
bladder, in gravel, and in gout, and enjoy a great re- 
putation as solvents of calculi. It is not very easy 
to explain the action of these waters, as some patients 
are purged by seven or eight glasses of them, while 
others can bear even twenty or thirty of them without 
being affected. We are gravely assured that there never 
has been a relapse among the many patients who have 
been cured of gravel at this place. Granting the com- 
plete cure, perhaps this need not be disputed. 

Since 1864 a company has managed the place and 
improved it greatly. These waters are largely exported. 

Pougues. — Much has been done of late years to revive 


the fame of this once popular bath, and to make it 
agreeable to visitors. It lies in the valley of the Loire, 
in a pleasant country not far from Nevers. It contains 
about twenty-two grains of ingredients in the sixteen 
ounces, with something like nine grains of carbonate of 
lime, six of magnesia, and four of soda, and some 
carbonic acid. But as the quantity of the last is not 
great, these waters, when bottled for exportation, have a 
supply of that gas added to them. They are popular 
in dyspepsia, gravel, and catarrh of the bladder, 

Alzola, in the province of Guipuzcoa, in a picturesque 
gorge, easily got at, by rail to San Sebastian, and thence 
in a few hours by carriage, is called the Spanish 
Vichy, and has of late years rapidly sprung into repute. 
Its waters, of a temperature of about 87 , appear to be 
only weakly impregnated with a little carbonate of lime 
and some common salt ; but there is no recent or complete 
analysis of them. 

These wells, like some other weak waters, enjoy a 
very great name in affections of the kidneys and bladder, 
especially spasmodic ones of the latter and of the urethra ; 
also in affections of the spine, where there is loss of 
nervous power. The peasants come in and drink these 
waters in winter for their coughs. The waters are drunk, 
two or three glasses before breakfast, and they are also 
used in baths. Seventeen days is the time in which they 
are expected to produce a cure. 

I know of more than one English family that 

o 2 


derived great benefit from this place. One family visited 
it for five years successively; but the patients are 
almost all Spanish. The hotels have greatly increased in 
number of late years; there are good tables tfhdte, at 
which sixty or seventy people sit down ; the food is 
abundant, and the wine excellent ; still there are many 
things that a fastidious Englishman has to put up with. 
The environs are beautiful, with great variety of land- 
scape. The season is from the ist of June to the end of 

FiterOy Old and New, on the borders of Castile, 
Navarre, and Arragon, with waters of a temperature of 
1 1 7*5°, containing chiefly lime, and of which a fresh ana- 
lysis is much wanted, is in much repute in the north of 
Spain. A correspondent writes : " They go there chiefly 
for rheumatism and paralysis. My wife and I could not 
regain our strength after an attack of cholera — we both 
were yellow and looked like ghosts; we were sent there 
in November, and found the place covered with snow; 
we had to get food as best we could, but all the same we 
got well. I have been three times to Fitero. At half an 
hour's walk are the sulphur and cold waters of Cerdela, 
used to strengthen the stomach, and for skin complaints. 
There is excellent accommodation, and it is altogether a 
fine place. In Fitero and Cerdela even the dust along 
the roads is balsamic !" Though these waters are drunk 
also, their use in baths is probably most efficacious. The 
season is from the ist of June to the end of September. 


Cransac deserves special notice among earthy waters, 
as being the only well in use which contains considerable 
quantities of alumina, and also very distinct traces of 
manganese; it is situated in a pretty valley in Auvergne, 
near an old volcanic hill, from which sulphurous fumes 
still exhale, and in which dark caverns have been exca- 
vated, in which patients can inhale hot air charged with 
the fumes. 

There is uncertainty about the analysis of these 
waters; but they undoubtedly contain large quantities 
of sulphates of lime, magnesia, and still more of 
alumina. The well in which the alumina predominates 
(at least 16 grs. of sulphate of alumina in the pint) 
seems to cause constipation, while the one containing 
a considerable amount of sulphate of magnesia purges, 
when used in the quantity of five or six glasses. These 
waters have a special reputation in enlargements of the 
liver and of the spleen, and in obstinate intermittents, 
for which the small quantity of manganese present has 
got the credit, and of late years they have been largely 
resorted to by the French, as being eminently tonic 
There is very poor accommodation for visitors, who 
usually lodge in the neighbouring town of Aubin. 



A little has been already said on the action of sulphur 
water in baths, and something more must be said on 
the difficult question of the effect of sulphur when taken 
into the system by drinking. The subject is made the 
more difficult by the discordance of opinion among 

Thus Lambron and others look on their effect as lower- 
ing and reducing the force and frequency of the heart 
and of the pulse, while at Bareges their effects are con- 
sidered directly exciting. Then it is affirmed that different 
waters affect different parts of the system. Eaux Bonnes, 
for instance, the respiratory organs; Eaux Chaudes, 
the digestive ; Luchon, the skin ; while Bareges has a 
specific effect on old wounds and ulcers. Then there 
is a considerable amount of jealousy between French 
and Germans as to the value of their sulphur waters ; 
and in some cases we are forced to believe that when 
the quantity of sulphur present is so minute, the virtue 
of the water may depend partly on the other salts it may 
contain, or on the temperature at which it is drunk. 



French writers have also laid much stress on a somewhat 
artificial distinction of sulphur waters into natural and 
accidental, according as they spring from primary and 
metamorphic, or from secondary and tertiary strata, 
according as the sulphur is united with soda, or with 
lime, and special virtues have been attributed to the 
presence of silicates in the Pyrenean waters. 

Among all these conflicting views it seems scarcely 
possible at present to arrive at the truth. 

The human system contains a good deal of sulphur, 
which is derived from the food in various combinations. 
Of the absolute physiological action of sulphur very 
little is ascertained ; its most palpable properties are, that 
it is slightly laxative, and that if it is long used, traces of 
it appear in the cutaneous transpiration. Its action is 
supposed to be analogous to that of hydrosulphuric 
acid. That acid is always generated in the system in 
certain quantities, especially in the intestinal canal. 
When inhaled in anything like a pure state, it is instantly 
poisonous ; when much diluted, its inspiration for a time 
is not deleterious : nay, as we have seen, it is beneficial in 
certain conditions. In its poisonous effects it appears 
to act directly on muscular contractility, and thus on the 
heart, the respiration, and the capillary circulation. 

The action of the sulphurets of potass, soda, and 
calcium seems to have much analogy with that of hydro- 
sulphuric acid. It has been proved that the sulphur of 
sulphuret of potass is absorbed. It passes partly into the 


blood, where it soon gets oxidized. If too much is taken 
into the blood, the surplus seems to be deposited in the 
muscles and bones : it is eliminated partly through the 
urine, and partly through the breath and the perspiration, 
in the shape of hydrosulphuric acid. It has further been 
supposed, but this is purely hypothetical, that the alkaline 
sulphurets of the waters may render albuminates of 
mercury and of other metals retained in the system, 
soluble, and even that the sulphur combines directly 
with them, and so aids their elimination, which does 
not seem likely, as most such sulphurets are insoluble; 
possibly, if they cause increased activity of the liver 
tissue, a quickened metamorphosis of liver cells and 
increased secretion of bile may afford a simpler expla- 
nation of their action. Sulphurets act more powerfully 
than sulphur itself. 

A few facts of a practical bearing respecting the ope- 
ration of sulphur waters have been ascertained. That 
they are on the whole rather constipating, their aperient 
action being the exception. They all increase the 
amount of the secretion of the kidneys, some say of the 
quantity of urea. They do not improve the appetite, 
though they do not exactly impair it The alvine excre- 
tions after a time get black and offensive, iron sulphurets 
are found in them, procured either from the food in the 
intestinal canal, or from the blood. It seems further to 
be pretty well ascertained that, under the continued use 
of sulphur waters, enlarged livers diminish in size, and 


the system is apt to get anaemic. The theory of the 
anaemia has been supposed to be, that the blood- 
corpuscles may be diminished, owing to sulphur rob- 
bing them of their oxygen, in order to form hydro- 
sulphuric acid. When their use is long continued, 
symptoms come on of what is called saturation, an 
inability to drink more without loathing, and among 
other affections even a certain catarrhal affection of the 
throat, which the French have called Grippe. 

Sulphur waters are used internally at most spas, to 
aid the operation of the baths in the diseases already 
enumerated in the chapter on Sulphur Baths. In Ger- 
many they are considered to act favourably on the 
haemorrhoidal diathesis, making the circulation of the 
liver more active, diminishing abdominal plethora and 
local haemorrhoidal congestion : whether this opinion is 
derived from the use of sulphur in some popular reme- 
dies for piles it is difficult to say, but it is widely spread 
in Germany, though not shared in by the English. On 
this account, and because the liver appears to be the 
great receptacle of metals, the sulphur waters are much 
drunk in metallic poisoning, and they have been con- 
sidered useful in malarial cachexy and in enlarged spleen 
and liver. 

In early tuberculosis, and in some bronchial affections, 
the drinking of these waters, particularly when warm, 
is used in aid of the inhalations of hydrosulphuric acid. 
The inhalation of that gas, which must always accompany 


more or less the use of the waters, either in drinking 
or in baths, has been alluded to already. 

The majority of the sulphur waters employed mainly 
for bathing are also used in drinking. Those that have 
been described above need not be mentioned again, 
and I shall only make an exception in favour of Aix-la- 

Five cold springs that are much used in Germany, agree 
in the main as to the mode in which they are employed. 
They are little known to the English. They are much 
cheaper and quieter places than they like to frequent. 
Two glasses, gradually increased to six or eight, are drunk 
before breakfast. In all, I believe, there are inhaling 
rooms, where the hydrosulphuric acid has been sepa- 
rated from the waters, and is used mixed with a certain 
amount of atmospheric air. In other places aqueous 
vapour is impregnated with gas. These are : 

Weilbach, in Nassau, where the operation of sulphur 
waters used internally has been chiefly studied. The 
water is exported. Though easy of access, it is not a 
very tempting place of residence. 

Nenndorf, in Hesse, with sulphur mud baths, inhaling 
apparatus, and whey cures, and also salt-baths, in a 
pleasant country, with good arrangements. 

Eilsen, in Lippe-Schomburg, offering much the same 
things to its guests, lies in a pretty open valley, but not 
much frequented. 

Langenbriicken, in Baden, in a pretty valley between 


Brucksal and Heidelberg, the same, and with a pleasant 
country and climate. It has, however, a much larger con- 
course of visitors, although the accommodation for them 
appears to be limited to what the Kurhaus supplies. 

Meiniberg, in Lippe-Detmold, offering in addition a 
pneumatic apparatus, and situated on a pleasant spur of 
some wooded hills, on a larger scale than the others, and 
holding out more inducements to visitors, and, with its 
drinking well, containing so much salt, that it might be 
counted among salt waters. 

Aix-la-Chapelle, and the neighbouring waters of 
Burtscheid, are believed to owe a good deal of their 
virtues to the chloride of sodium, 20 to 21 grs. in the 
16 ozs., which they contain. The source " Elisen" is the 
one most used for drinking ; it is disagreeable at first, 
but people get accustomed to it, and even to like it. 
They begin with 6 or 8 ozs. and increase it gradually 
to three or four times that quantity. As its temperature 
is about no°, patients walk up and down, tumbler in 
hand, till it cools. 

. Besides having the general operation of sulphur 
sources, the water of Aix-la-Chapelle contains enough 
of salt to make it produce many of the same effects as 
Wiesbaden and other thermal salt waters, so that the 
operation of its springs, when drunk, is believed to com- 
bine the effects of salt and of sulphur waters. While 
Weilbach has got a special name for the treatment of 
phthisis, associated with fatty liver, and of cases of 


enlarged liver, it is difficult to see why the same cases 
might not be treated with advantage at Aix-la-Chapelle. 
The former certainly has somewhat the advantage in 
point of climate. Aix water has of late years been 
exported a good deal. 

Some Swiss springs of ordinary temperature will next 
engage our attention. Their establishments are on a 
small scale, and chiefly resorted to by the natives ; but 
they are in the midst of such beautiful scenery, and 
some of them, such as Gurnigel and La Prese, are so 
elevated, that it is surprising the English do not oftener 
turn aside to them. The arrangements in all have 
rapidly improved of late years. But they are all on quite 
a small scale after the baths of Germany and of France. 

Stachelberg lies at the height of about 2,000 feet, at the 
end of the Lin Valley, in Glarus, in some of the finest 
and grandest scenery in Switzerland. Its waters only 
contain about 4 grs. of mineral constituents in the 16 ozs. 
They contain, however, abundance of carbonic acid gas. 
The place is immensely crowded in the season. Drinking 
the water and bathing in it are both practised, and the 
diseases, especially the cutaneous ones usually treated 
with sulphur waters, are the subject of treatment here. 
But affections of the chest are specially benefited by the 
waters, mixed with milk or whey ; there is a whey cure. 

Lenk, near Weissenburg, is a promising new bath. 

Gurnigel, which has of late risen into importance, lies 
among the mountains to the right as you go from Berne 


to Thun. It is 3,850 feet above the sea. The waters 
contain sulphate of lime. They drink the water in large 
quantities ; but when they exceed ten glasses per diem, 
symptoms of saturation occur. These waters are used 
much in dyspepsia and hypochondriasis, in congestion of 
the liver, and in bronchial catarrh. There is a handsome 
bathing establishment, and also provision for the poorer 
class of patients. 

Heustrich is in a valley not far from Thun and the lake 
of that name. It is distinguished from the other sulphur 
springs by containing a little carbonate of soda, but only 
somewhat over 6 grs. in i6ozs. To this, however, its 
efficacy in chronic bronchial catarrhs is attributed. In 
these it has a very great reputation. The arrangements 
are most comfortable. 

La Prese, a little off the high road from the- Engadine 
into Italy, with romantic scenery and a beautiful little lake, 
3,000 feet above the sea, is completely sheltered from 
the north and north-east, and enjoys a wonderfully mild 
climate. The waters contain sulphate of lime ; but the 
source of this and of the four preceding stations are 
feebly mineralized. Now that the current has set in so 
much towards the east of Switzerland, this place may 
meet with the attention it deserves. Good whey is sup- 
plied, and baths of whey, and also the fresh krauter 
safte are to be found. A sheltered place like this, at so 
considerable an altitude, may be found useful in many 
pulmonary affections. 


Switzerland is wonderfully rich in sulphur waters; 
many others might be mentioned, such as Alveneu, not 
very far from St. Moritz, and I may be excused for 
mentioning the Moffettas, or gas springs, not far from 
Tarasp, issuing from certain clefts with such strong 
vapours of sulphuretted hydrogen, that dead beetles and 
frogs, and even mice and birds, are to be found around 

France, so rich in thermal sulphur springs in the 
Pyrenees, is not so well supplied with cold ones. Almost 
all the Pyrenean springs already enumerated are used for 
drinking as well as bathing. I shall only mention two 

La Preste, high up in the mountains, along the river 
Tech from Amelie. It can only be reached by mules, 
and, though within French territory, is quite Spanish. It 
is situated in a savage gorge. The well is of the 
temperature of n8°. The supply of water is ample. 
It is chiefly used internally for lithiasis and catarrh of 
the bladder. Its season is from June to the end of 
August. There are interesting grottoes with stalactites. 

Visos, a cold sulphur and bituminous spring, near 
St. Sauveur, is a good deal drunk by people frequenting 
that bath. It has no establishment ; and has a great 
reputation in ulcers and old wounds, also in chlorosis, 
because it is supposed to contain iron. It is exported 

Allevard, in a beautiful Alpine valley, between 1,400 
and 1,500 feet above the sea, with very charming 


scenery, one hour's drive from the Grenoble railway, 
has risen into importance within the last forty years, as 
a cold sulphurous spring. 

There is some difference of opinion respecting the 
constitution of its waters. The mineral contents are 
very small; while they contain quite as much hydro- 
sulphuric acid gas as Eaux Bonnes, these springs have 
a great deal more carbonic acid. It is said that the 
presence of this large quantity of carbonic acid makes 
the waters sit more lightly on the stomach than most 
other sulphurous ones; while the quantity of nitrogen 
also present, is of use in the cold inhalations of the 
hydrosulphuric acid, which are practised here, as well as 
warm ones, with great success in affections of the chest. 
These waters are employed in all cases in which sulphur 
waters are used, but specially in the diseases of the 
respiratory organs. The arrangements here are ex- 
cellent, and the place is well worthy of being better 
known to the English. There is a whey cure. 

Enghien, with its pretty lake, is not far from Paris, and 
has indeed become almost an annexe to it. It has mild 
sulphur waters, used both for drinking and for bathing. 
They have the usual effects of sulphur wells; but as 
English in search of health are not likely to stop short at 
Enghien, it seems unnecessary to enter into details. . 

Caratraca, some leagues from Malaga, is probably the 
most visited watering-place in Spain. The country about 
is beautiful, the climate delicious, and there is plenty of 


amusement to be had. The water, of a temperature of 
about 66°, is but feebly mineralized, but it enjoys a great 
reputation in skin complaints, in scrofula, and in 
bronchial catarrhs. It is used for drinking, bathing, 
vapour baths, and injections. Season from 15th June to 
30th September. 

There are also Ormeztaguy, cold sulphur, near Tolosa, 
and Santa Agueda, to be mentioned again for its iron 
waters, belonging to the group of wells near San 
Sebastian, so worthy of further investigation. They are 
much resorted to by the Spaniards. 

Great Britain, poor in thermal springs, is also poor in 
sulphur ones ; and the well which used to be considered 
the type of English sulphur fountains, the old sulphur 
one at Harrogate, contains so very large a quantity of 
common salt, 108,272 grs. in the 16 ozs., that it must 
take its place among the salt springs. 

Gilsland Spa, near the borders, on the railway between 
Carlisle and Newcastle, is prettily situated in a broken 
country, in the neighbourhood of the old Roman wall, 
and of one of its most remarkable stations. According to 
old analyses, the well, while very free from mineral con- 
stituents, would seem to contain about two inches of 
hydrosulphuric acid in the sixteen ounces, (?) a very con- 
siderable proportion. Gilsland has also an iron spring. 
The waters are believed to be useful in dyspepsia, 
chronic rheumatism, and skin complaints. 

The place is much frequented in autumn, chiefly by 


people from Liverpool and the West of England. If 
the waters be not very powerful, yet I know no place in 
England, where people of moderate means can get more 
in the way of pleasant relaxation, often as useful as 
medicine, than here. That the cases of illness treated 
are not very acute, seems plain from the fact of there 
being no resident doctor. 

Moffatt, in the south of Scotland, in an interesting 
country, with a somewhat damp climate, has long been 
a favourite watering-place. It, like Harrogate, only in 
a minor degree, contains a good deal of chloride of 
sodium, about as much as Aix-la-Chapelle. Its chief 
constituents are, in twenty ounces : hydrosulphuric acid, 
2*65 inches; sulphate of lime, 1*19 grains; sulphate 
of soda, 2*07 ; chloride of sodium, 22*07. It therefore 
is by no means very unlike Aix-la-Chapelle, having the 
same quantity of common salt, and perhaps more 
hydrosulphuric acid, but its waters are cold. Moffatt 
has maintained its position very well. An old author's 
account of the action of its waters is as follows : — " It 
proves mostly an alterant and a diuretic ; it generally 
opens the belly, and it purges some people." Like 
other sulphurous waters, it has been much used in 
cutaneous affections and in chronic obstructions. 
Moffatt has much to recommend it. 

Strathpeffer, in a narrow valley in a very picturesque 
country, at the foot of Ben Wyvis in Ross-shire, our 
most northern spa, has four (two principal) sulphur 



wells. The pump-room, or new well, according to Dr. 
M. Thomson's analysis, would seem to contain in the pint 
about 1 2*5 grains of sulphate of lime; 3*5 carbonate of 
lime; 7*5 sulphate of magnesia; 7 *5 sulphate r of soda; 
sulphuretted hydrogen, nearly three inches (?). The upper 
well contains only half the amount of lime, and about 
one quarter more of magnesia, They are undoubtedly 
strong sulphuretted waters. 

The usual dose of these waters is three tumblers before 
breakfast, and three more in the afternoon. Baths can 
be had, but they are little used in the treatment. 

These waters, which appear to be strongly diuretic 
and usually slightly constipating, are believed to 
be very efficacious in rheumatism and in dyspepsia, 
and in cutaneous affections. They are greatly fre- 
quented by the people of the country, who come from 
long distances and drink the water in enormous quan- 
tities, but the arrangements are very imperfect, and 
living is by no means cheap. However, there is a 
large resort, the clerical element predominating, to these 
wells, which are very celebrated in the north of Scot- 
land, and it would no doubt be increased if a higher 
style of accommodation were given, and this will 
certainly follow the formation of the new railway to 
the Isle of Skye. 

Ireland is very poor in wells of all kinds. The wells 
of Swardiribar and of Lisduvarna scarcely deserve 
mention, so far as their mineralization is concerned. 



nor do they offer such accommodation as can attract 

Before leaving the subject of sulphuretted waters, I 
shall give the following table, which shows how difficult 
it is to connect the action of such waters with their 
containing any considerable quantity of sulphur. The 
Pyrenean waters, though smelling strongly of it, contain 
only traces that can be detected by chemists, and their 
virtues are believed to reside in sulphuret of sodium. 
It is very doubtful whether the analyses giving large 
quantities of hydrosulphuric acid set down to Gros- 
wardein, and perhaps to some of the others, are really 
trustworthy. The table gives the cubic inches of the 
gas in 1 6 ozs. The sulphuret of soda is in grains to 
the 1 6 ozs. 




of Soda. 

Aix-la-Chapelle . . 

. o«5 . . 

. • — 

Burtscheid. . . . 

. 0*12 . i 

• • 4^34 

Weilbach .... 

. o*i6 . . 

. — 


. i -si . . 

, , — 

Schinznach . . . 

. 172 . . 

. • — 

Bareges .... 

trace . . 

. . 0*360 

Eaux Chaudes . . . 

do. . . . 

. C893 


do. . . 

. . C476 


do. . . . 


Groswardein .... 

5*34 • • • 


Strathpeffer .... 

17 • • . 


Harrogate .... 

o*66 . . . 


P 2 



The common salt, or chloride of sodium waters, form 
a tolerably natural group, and one might have supposed 
that by this time the precise action of so ordinary a 
substance as culinary salt on the human system might 
have been accurately ascertained; but our knowledge 
of the subject still remains very general. 

It is not surprising that chloride of sodium is abun- 
dant in the human body, as it is a constituent of almost 
all our food and drink. It has been calculated that a 
full-grown man may have from 800 to 1,800 grains of 
salt in his system, and the daily supply taken in has 
been calculated at from 90 to 300 grains. Salt forms 
from 40 to 45 in 10,000 parts of blood; it is a con- 
stituent of most of the secretions, of watery transudations 
in disease, as in cholera, and accompanies the secretion 
of urea. 

Its physiological effects have been thus described: 
first, introduced into the stomach and added to the 


food, it, as a solvent, extracts from them their albumen 
and starch; next, it helps to pass on to the bowels a 
soft mass well supplied with these substances ; thirdly, 
it furnishes a sufficient supply of itself to the blood for 
the purposes of absorption, secretion, and change of 
tissue, without permanently overloading the blood, as 
its excess is quickly excreted again. 

An increased use of salt may be considered to 
augment temporarily the amount of salt in the blood 
and in the secretions. The secretions become more 
abundant, change of tissue is accelerated, the action 
of the alimentary canal and of the generative organs 
is slightly stimulated ; no direct action on the- nervous 
system has been observed. 

When taken in too large doses, it may cause con- 
gestion and inflammation of the alimentary canal and 
kidneys (possibly of the brain), of the conjunctiva, and 
the nasal passages. On the whole salt may, in a general 
way, be said to have the power of rousing the vital 

Therapeutically, salt acts through the capillaries on the 
stomach, increasing the secretion of the mucous follicles ; 
it also exerts a similar influence on the bronchial sur- 
faces and on the skin. It stimulates the liver as a 
cholagogue, and promotes a healthier activity of its 
functions ; as an aperient, which it always is when taken 
in considerable doses, it is useful in obstructions of the 
circulation of the portal system. It also favours absorp- 


tion, undoubtedly often removing fat when it is exces- 
sive, and glandular infiltrations.* 

Salt waters require to be carefully employed, as their 
protracted use is debilitating. When used too long 
and in too great quantity, they may produce loss of 
appetite, giddiness, drowsiness, biliary derangement, 
diarrhoea, and irritative fever. Those waters which contain 
most carbonic acid are pleasantest, and most easily 
borne by the stomach; but especial care is needed in their 
employment in the case of those who are full-blooded. 

Salt waters axe probably more useful in improving 
certain states of system, than in acting specifically on 
structural changes of particular organs. First in the 
list of these states comes scrofula ; but a good deal has 
already been said of it in connexion with salt-bathing. 

There are two forms of anaemia which benefit much 
by salt waters, that of women, and tropical anaemia. In 
such cases the question has always to be decided, whether 
the case is to be treated at once with iron — whether it is 
better to present iron directly to the system, or to endea- 
vour to get the system into such a state, that it may be 
able to assimilate the iron presented to it in the various 
articles of food. It may often be best to begin with salt 

* I am only aware of a few applications of common salt in ordi- 
nary medicine : as a vermifuge, in which it has often seemed to me 
to be a very useful adjunct to the bark of the pomegranate root ; as 
a febrifuge it has been used a good deal by the French and the 
Americans. Salt as a domestic remedy is useful as an emetic, and 
as an addition to enemas. 


waters, in small doses, especially when there is irritability 
of the alimentary canal, or congested state of liver. Prac- 
tically I have often been disappointed in the use of iron 
in such cases. Some recent researches point towards 
the settlement of these questions. It has been found 
that chloride of sodium does not, like chloride of potass, 
cause a copious elimination of iron in the urine ; on the 
contrary, it appears greatly to favour the assimilation of 
that metal. It had been shown formerly that iron, when 
given internally, is not absorbed of itself, without the 
favouring agency of chloride of sodium. The great 
desideratum, therefore, would be a well containing iron 
and salt in such proportions as to make them readily 
absorbed, and without that predominance of salt which 
makes the use of any considerable quantity of such 
waters cause purgation; but no well exactly of this 
character has been yet discovered. The Luisen well 
at Homburg is an approach towards it. Chlorotic 
anaemia will be afterwards alluded to. Here a few words 
about the tropical form may not be out of place. 

By Indian cachexy, and the French have described a 
similar state in Algiers, is meant the result of longer or 
shorter exposure to heat, moisture, and malaria ; I mean 
the general condition induced, whether by general atmo- 
spheric influences and long residence, or by repeated at- 
tacks of fever, liver, or dysentery. Even after the chronic 
diarrhoea, so often an obstinate adjunct of this state, has 
been got over, there remains very generally with torpor of 


the liver, perhaps along with that odd symptom burning 
of the feet and hands, a general relaxation of the system, 
manifested in a great liability to catarrhal attacks, with 
frequent elongation of the uvula, and often in women 
with leucorrhoea. There is a general want of red 
blood, and deficiency of fibrin manifested, as I have 
known, by troublesome haemorrhage after trifling ope- 
rations, such as snipping off the uvula or the extraction 
of teeth. From this latter cause I have more than once 
seen very serious effects follow. In such conditions, 
where it must always be a matter of time, recovery may 
be materially assisted by a visit to many of the salt 
springs ; in short, when the symptoms of general cachexy 
predominate over local affections. 

Dyspepsia is very often benefited by the use of salt 
waters. Here the choice lies very much between salt 
and alkaline waters, unless a very free action of the 
bowels is required, when some of the more purging 
waters are indicated. In chronic diarrhoea there is 
some evidence that these waters are of use when 
given in small doses. Liver and spleen are said both 
to diminish under the use of these waters. I have no 
doubt that they do ; but for the former, alkaline or pur- 
gative waters are more adapted, and for the latter, purga- 
tive or steel ones. Cases are reported of spleen cures 
with salt water, and, considering the analogy of the action 
of chlorides with that of iodides and bromides, there is 
nothing improbable in this; salt are undoubtedly more effi- 


cacious than alkaline waters in such cases, but there seems 
to be no sufficient evidence of any direct action on the 
spleen, and in spleen I should have more confidence in 
the usual medical treatment than in mineral waters. 

Salt waters are extremely useful in a great variety of 
female complaints depending on general relaxation of 
the system in older, and on imperfect development in 
younger patients. A great deal of unnecessary local treat- 
ment is often saved by a visit to a salt spring, especially 
when the patients are once got to believe that the local 
treatment is unnecessary, and I venture to say that one 
half of it might be omitted with advantage. No doubt 
chronic congestions and hypertrophy of the uterus are 
frequently removed, and its functions restored; no fibroid 
or other tumours are ever really dispersed. 

Some congestive states of the eyes, such as choroi- 
ditis or inflammation of the ciliary body, occurring 
chiefly in women, and connected with feeble circulation, 
and not amenable to ordinary treatment, are often 
greatly benefited by alterative waters like those of 
Kissingen and Homburg, or steel ones like Schwalbach. 
Many baths have wells that have got the name of eye 
wells. I need hardly say that there can be no specific 
action in such cases, any more than in cases of deafness 
which may benefit by the favourable operation of such 
waters on the general health. 

Patients going to the most popular baths in Europe, 
such as Homburg and Kissingen, or to Harrogate in 


this country, are seldom aware that the chief constituent 
of the waters they drink, is common salt. 

The following table shows the quantity of common salt 
in grains, and of carbonic acid in inches, in 16 oz. of some 
of the principal springs ; also the presence or absence of 
iron, and of the carbonate and sulphate of lime. I have 
included muriates under the same head as carbonates. 

»r Common Carbonic T " Carbonate Sulphate 

Temp. g^ ^ Iron. of j^ offt^. 

Nauheim . 8o° to 103 124 20 0*19 12 — 

Homburg . — 76 48 046 17 — 

Kreutznach . — 72*8 — 0*199 1 3 — 

Soden . . — 94 42 — 8*3 — 

Wiesbaden . 156 57 6 — 6*8 — 

Bourbonne . 149 51 18 — 8 6 

Kissingen . — 45 41 0*24 8 2*5 

Pyrmont . . — 54 23 — — 6 

Cronthal . . — 28 33 0*25 5 — 

Canstatt . . 75 19 23 — 7 '3 7*5 

Baden Baden 155 17 1 — 1*2 1*5 

Harrogate K.W. — 82 3 0*373 20 — 

do. M.W. — 26 3*2 3*23 17 — 

Diirkheim . — 49*2 — — 18 — 

Bridge of Allan — 47*5 — (muriate) 38*4 — 

Sea water* has frequently been used internally. The 

* An average analysis of its constituents has been already given ; 
another one is added of the water of the German Ocean. 

Chloride of sodium 195* 

Chloride of magnesia 34* 

Sulphate do. 5*4 

Bromide do. . , 2*5 

Sulphate of potass 1 1 *7 


ancients often used it in that way, and indeed they 
used to mix it with some of their wines, thinking that 
a small quantity, about a thirtieth part of it, improved 
their quality. 

Of late years French writers have been enthusiastic 
in its praises. They have said that sea water is a true 
mineral water, extremely rich in saline principles, 
containing in itself almost all the most valuable 
medicines. It has lime to harden our softened bones, 
iodine to purify our blood; it has heat concentrated 
in it with a " Je ne sais quoi " of something unknown, 
a gelatine or mucus, which bestows form and life. 
More of this sort of thing in Michelet. 

Salt water was, however, about a hundred years ago, 
used extensively in this country, and it may be well to 
see how its action was then described. 

" Taken internally in small quantities, it proves a 

stimulating, healthy remedy, dissipates the finer fluids, 

and increases thirst Taken in larger quantity, it 

proves purgative, often at the same time causing thirst. 

What is remarkable of the use of it is, that patients 

often drink it daily for a considerable time in such 

quantity as to purge, and that instead of losing 

they gain strength by it, which is certainly owing to, 

besides its purgative action, its giving a stimulus to 

the stomach and the intestines, increasing the appetite, 

and improving digestion, whereas most of the common 

purgative medicines pall the appetite and dissolve the 


blood at the same time that they cause large evacuations, 
which weaken the system. 

" From our being able to keep up a purgation for a 
considerable time without hurting the constitution, we 
frequently by salt water remove disorders which have 
resisted other remedies. Dr. Russell wrote that he 
found few glandular swellings, which had not already 
suppurated, which he had not been able to remove by 
the use of sea water. This is perhaps too general an 
assertion, though it has been found most serviceable in 
removing recent scrofulous swellings in the neck and lips, 
and scrofulous ophthalmias, especially when joined to 
the use of bark. Sea water has likewise been found 
to be extremely serviceable in purging off gross humours 
which have been the consequences of indulging the 
appetite too freely, and leading too indolent and lazy 
a life, and in clearing the intestines of viscid mucus 
and of worms." 

These remarks of Dr. Munro have appeared to me 
worth preserving, as they illustrate what has been 
already said about the use of salt. I have no doubt 
that the action of salt water is truly enough described 
by him; but though we hear occasionally of patients 
drinking salt waters, it is a disagreeable and unpleasant 
remedy, never likely to come into fashion again. 

Kissingen, in the pleasant valley of the Saal in North 
Bavaria, has not yet been reached by a railway; but 
it is only about two hours' drive from Schweinfurth, and 


nearly three from Gmunden. It has long been one of 
the most favourite of modern watering-places, and a 
great resort of English ; the writings of that patriarch 
of English Balneology, Dr. Granville, having contributed 
greatly to this. It has much to recommend it. 

The Rakotzky is one of the milder salt springs, with a 
plentiful supply of carbonic acid, and a quite appreciable 
quantity of iron. The Pandur agrees closely with it. 
A milder spring, the Maxbrunnen, is a delicious table 
drink; the Sool-bad, about a mile off, with its wellen- 
bad (supplied from that magnificent well, the great 
Sprudel, with its intermittent flow), is invigorating; and 
only four miles off is Bocklet with its strong chalybeate 
spring. The arrangements of all kinds are excellent. 
There is a handsome Kursaal; there are good hotels 
and lodgings, and pleasant excursions to be made in the 
neighbourhood. There is not so much dress or folly 
here as at Homburg, nor are the tables d'hote so 

The English often complain unreasonably of its being 

The waters were to me more palatable than those of 
Homburg, being less salt The general indications for 
the use of waters of this sort have been already given. 
They are the waters about which the English public 
has heard most, so need not be described at large. 
The action of the water is milder than that of the 
Homburg ones. The water is drawn up on sticks 


from the well, but the arrangement of open wells with 
girls to hand up the water is pleasanter. 

Homburg is reached by railway, and being near Frank- 
fort, is very centrally situated. Everything has been 
done to make it attractive to strangers ; the magnificent 
reading and ball and gambling rooms are open to all ; the 
grounds are extensive and beautifully laid out ; the wells 
are abundant and various ; so that it is not surprising that 
the place has attained a wonderful degree of popularity. 
Its wells may, on the whole, be described as a more 
powerful Kissingen ; and the place being more open, and 
standing higher, on the slope of a hill, makes the heat 
not feel so oppressive as in Kissingen. At this moment 
Homburg is the most popular bath in Europe. 

French, English, and Americans quite outnumber 
the Germans. Here comes the fine lady to recruit 
from the dissipation of the last season; the bon-vrvant 
to repair his digestion after the good things he has been 
indulging in ; the clergyman, or the man of business, 
for relaxation. You have leading statesmen and capi- 
talists meeting all the black-legs of Europe. Still 
there is an immense deal of benefit to be got from the 
waters; but for the reason which led me to say little 
about Kissingen, I shall not say much about Homburg. 

An analysis of the Elizabethbrunnen is given in the 
table ; the Kaiser has only 55 grains of salt, and as much 
iron ; the Ludwig, 40 grains, and no iron ; the Luisen, 
23 grains of salt, and '33 of iron. The waters are mainly 


drank, and three glasses of the Elizabethbrunnen have 
generally a very distinct aperient effect. Baths of all 
kinds are supplied here; but Homburg is not a place 
to go to for bathing. The carbonic gas inhalation-rooms 
are not much used. 

Only a very few words are required about some places 
whose waters are mainly used for bathing and have been 
already mentioned, but are also employed internally. 

Kreutznach. — The Elisenbrunnen is chiefly used for 
drinking, and notwithstanding the absence of carbonic 
acid gas is less disagreeable than might have been 
expected. It is considered an important adjunct to the 

Nauheim. — The chief drinking spring is somewhat salt 
and unpalatable ; the milder one is mawkish, but the 
pleasant acidulous waters of Schwalheim are only a mile 
off. They are drunk a good deal at Nauheim, and 

Wiesbaden is more of a bathing than of a drinking 
source ; still its waters, with their chicken-broth smell, 
are well suited for cases where a moderate action of 
chloride of sodium is desired. They are applicable in 
some forms of indigestion, and in atonic gout, in 
enlarged liver, and even spleen. 

Baden Baden. — The waters of this place are still 
milder, and much the same may be said of them as of 
the last, only that their action is slighter. 

The Bourbonne and Balaruc waters are both used 


almost entirely for bathing in these days, but are also 
occasionally used internally. 

Pyrmont^ known better for its iron springs, which will 
be mentioned afterwards, has a pleasant salt spring 
with a moderate amount of salt and plenty of carbonic 
acid gas. 

Soden, at the foot of the southern slope of the Taunus 
mountains, has a number of salt springs of lukewarm 
temperature. The place is cheerful, and nicely laid out. 
It makes a convenient change from Homburg, but has 
many saline rivals in its neighbourhood, as Nauheim, 
Homburg, and Cronthal. The climate, like that of 
Wiesbaden, is counted mild, at least for an inland one, 
and in consequence Germans recommend the place in 
threatened phthisis. Some of its wells contain from 
•2 to *3 grains of iron. 

Cronthal) half an hour's walk from Soden, and prettily 
situated a little higher, makes another pleasant change 
from Homburg. Its waters are very mild, the strongest 
well having only twenty-seven grains of common salt in 
the sixteen ounces. 

Canstatt, adjoining Stuttgard, has its warm wells and 
baths at the foot of a low hill laid out in gardens, and 
having beautiful views up the valley of Stuttgard. The 
climate is mild. The waters offer a moderately strong 
supply of salt, with a small one of iron. They have con- 
siderable repute in dyspepsia and other affections not 
requiring more active waters. There are many English 


resident in Stuttgard for educational and other purposes, 
and they might make more use of these waters than 
they do. 

Ischia^ an hour and a half by steam from Naples, at 
the northern corner of the bay ; whether this island be 
an epitome of the universe, as it was called by Bishop 
Berkeley, or not, it is probably the most interesting bath 
in the world. The variety and the abundance of its 
sources both in caloric and in mineral constituents, the 
beauty of its scenery, its delicious climate, and its 
historical associations, distinguish it from all others. It 
combines the advantages of sea-air and sea-bathing with 
those that are special to its wells, and almost its only 
drawback is its insular position. Plenty of accommoda- 
tion can be had. There are excellent lodgings on the 
hills above the village of Casa Micciola, where the air is 
much cooler than down below, and bracing as compared 
with the air of other Italian places in summer. A good 
many English resort to Ischia. 

There are fourteen sources in the island, varying 
from 7 2 to 170 in temperature; one is believed to 
come up to 21 2 , and one rises in the sea. They are 
essentially salt springs, with an unusual quantity of car- 
bonate of soda, and with a greater or smaller amount 
of the purging sulphate of soda, with a considerable 
quantity of carbonic acid. I have not seen the latest 
analysis of these waters, but some of them have been 
stated thus: — Capponi, common salt, 25*7; carbonate 



of soda, 10*55 ; sulphate of soda, 2-3 grains; carbonic 
acid, 2*3 inches. Gurgitello has been stated at : com- 
mon salt, 32 ; carbonate of soda, 30 grains ; carbonic 
acid, 9 cubic inches; but the quantities of solids are 
probably too high. 

The Bagno Fresco is believed to have the virtues of 
Schlangenbad, for the skin. 

Gurgitello is used almost entirely in baths. This is the 
water most employed and best known to strangers. 

Capponi, having the chicken-broth smell of some 
waters, is more drunk, is slightly aperient, and used 
chiefly for the digestion. 

Citara, beautifully situated., has long had the same 
virtues attributed to it as the Buben Quelle at Ems. It 
contains much salt, and is used chiefly in baths ; taken 
internally, it is very purgative. 

Acqua di St. Restituta is the strongest 

Olmitello has a reputation in calculous disorders. 

There are natural vapour baths at Castiglione and at 
Cacciuto, at San Lorenzo, and elsewhere, and the process 
of arenation is carried on here. 

It is evident that a great range of diseases may be 
appropriately treated at Ischia. In rheumatism, and in 
all diseases requiring active thermal treatment, these 
baths, with proper precautions, may be used with great 
advantage. The baths of Ischia are capable of much 
further development. 

Castellamare, near Naples, formerly Stabiae, contains a 


number of salt springs known to the ancients. They 
vary in strength, but their main constituent is common 
salt, with small quantities of carbonate of soda and some- 
what larger of sulphates of soda and magnesia. There are 
also chalybeates of various strength, one with a good deal 
of carbonic acid, another sulphated with hydrosulphuric 
acid ; it is therefore easy to see how these waters may be 
of much use in affections of the digestive organs. On 
the spot the different wells are considered to vary very 
considerably in their effects, and different wells are 
prescribed according to the nature of the malady; 
rheumatism, gout, obesity, cutaneous affections, being 
of the number. 

Pozzuoli. — The use of the old thermal waters at the 
temple of Serapis has been revived of late years, and 
they are in considerable repute at Naples. The tempe- 
rature of the hot spring is about 106 . These waters are 
weak salt ones, but they contain a good deal of soda, 
and one of them should be valuable in dyspepsia 
according to its analysis, which gives it carbonate of 
soda, 8 grains; ditto magnesia, 1*20; ditto lime, 1*50; 
ditto iron, -53. 

La Porretta^ lying between Pistoja and Bologna, is 
three hours by rail from Florence, in the valley of the 
Reno, at the foot of the Appennines, but at a height of 
1,100 feet; it has thermal springs of temperature from 85 
to ioo°, the main constituent of which is common 
salt — in the stronger wells reaching to 60 grains in 

Q 2 


the pint — containing a little sulphuretted hydrogen, 
and so much carburetted hydrogen, that it is collected 
for the purpose of lighting the little town. 

There is much variety in the strength of the waters, and 
they may be applied in consequence to the treatment of 
a great variety of affections. But their special reputation 
is in the treatment of cutaneous diseases, no doubt 
owing to the small quantity of hydrosulphuric acid 
they contain. Besides being drunk, the waters are also 
employed in baths and douches, and they may be used at 
their natural temperature. 

The arrangements of the place are fair, but it is scarcely 
visited by English, though with management they may 
do very well. There is a casino close to the spring 
where people may lodge, but in the village on the hill it 
is better and healthier. 

Monte Catini y between Lucca and Pistoja, in the valley 
of the Nievole, is a pretty enough place, and the most 
important salt bath in Italy. The arrangements are on 
a handsome scale, and in former times the Dukes of 
Tuscany visited it annually, and were its great patrons. 
There are hotels and lodging-houses. The strongest 
spring, the Terma Leopoldina, of about the tempera- 
ture of 93 , contains 140 grains of common salt in the J 
16 ounces ; a milder one is employed for drinking — 
it contains a little carbonic acid gas, and is of the 
temperature of 8o° to 8i°. Like other salt springs, these 
have been lauded for containing iodine. 


The stronger spring is used for bathing; the Tettuccio, 
a weaker one, for drinking. 

The Italian doctors consider these waters sovereign 
remedies against dysentery and ague, and enlargement of 
the liver and spleen. Constantine James even classes 
them with Carlsbad in hypertrophies of the liver; but 
there appears to be nothing in the chemical constitution of 
the waters, to make us expect any other results than those 
obtained at Homburg and Kissingen, and the absence of 
carbonic acid makes them much less pleasant to drink. 
However, it is very remarkable, how for centuries these 
waters have been praised in dysentery and in the conse- 
quences of inflammation of the bowels. 

The neighbouring grotto of Mosumanno is much used 
as a stufa or hot air bath. The grotto is dark, and as 
you pass on, you get gradually hotter and hotter till 
you reach the inferno, by which time you are bathed 
in the most copious perspiration; it is very useful in 
rheumatism, but much care is required to avoid chills 
after the process. The arrangements are somewhat 
rough ; people go in bathing clothes, which get saturated 
with moisture, after which the patients are packed in 
blankets and sent home. A good many English go to 
Monte Catini. 

Cestona. — The thermal salt waters of this place have 
obtained considerable popularity. Of a temperature of 
88° to 94 , they seem to contain chiefly common salt, 
forty-six grains, with one-third as much sulphate of lime, 


and about one-ninth of sulphate of soda in the pint. 
They are very distinctly purgative. The waters are used 
for drinking, for baths, and douches. They are used in 
rheumatism, disorders of the digestion, and in bronchitic 

There are good hotels, and the neighbouring country 
in the north of Spain is beautiful. It is one of the 
group of Spanish baths within easy reach of San Se- 
bastian, which comprise sulphurous, iron, carbonated, 
earthy, and chloride of sodium waters. 

Harrogdte y with the most important drinking waters in 
England, and therefore mentioned here at somewhat dis- 
proportionate length, has kept up its reputation ever since 
it was discovered. The place itself is ugly and not attrac- 
tive, but agreeable excursions can be made from it The 
air is bracing, and those who find the upper part of the 
town too much so, can reside in the lower and more 
sheltered part 

There are three wells, all very fairly pure salt ones. 
The old sulphur well, with 108 grains of salt, has barely 
12 of lime and 275 inches of carbonic gas ; the Kissingen 
well, 82 of salt and 25 of lime with a little iron, and 
3*02 inches of carbonic gas; while the mild sulphur well 
has 29 grains of salt and 4 grains of lime, 178 inches 
of carbonic gas. There is therefore considerable choice 
among these waters. 

A recent practical writer, who has had ample experi- 
ence of Harrogate, Dr. Myrtle, represents the action of 


these waters, taking the strongest as his type, as stimulant; 
increasing the- secretions from the stomach and the 
intestinal canal, acting also on the liver not only as a 
cholagogue, but promoting a healthier activity of its 
functions ; as an aperient, acting comfortably, and often 
removing habitual constipation; as a resolvent, causing 
rapid absorption of the fatty tissue in cases of obesity ; 
nay, even reducing chronic hypertrophy of the uterus, 
and gradually reducing glandular indurations and gouty 
and rheumatic swellings. He finds the purgative action 
of the water not so lowering as that of sulphates, 
citrates, and tartrates of magnesia, potash, and soda. 
Many patients take it in medium doses with comfort for 
weeks together. Usually it is not given for more than 
eight days to three weeks, but in some cases patients 
have expressed a liking for it, after it has been daily 
taken in full doses for weeks and even months, while 
the .patient shows no sign of being weakened by its use. 
If taken injudiciously, however, it produces, as the 
French would say, symptoms of saturation, constitutional 
disturbance, characterised by loss of appetite, thirst, 
giddiness, drowsiness, headache, biliary derangement, 
and fever. 

A pint to a pint and a half taken in half-pint doses 
at intervals of fifteen or twenty minutes, beginning an 
hour or hour and a half before breakfast, is generally 
sufficient to produce its aperient action. To secure 
its alterative action, from two to eight ounces are taken 


cold three or four times a day. When the digestion is 
weak the water is prescribed warm, as when taken cold 
it lies heavy on the stomach. The class of patients 
that improve most at Harrogate are cases of faulty 
digestion and assimilation, arising from purely functional 
or organic causes, or from a mixture of both, also men 
suffering from failure of nervous force consequent upon 

Who can fail to observe that these are exactly the same 
class of cases that benefit so much at Homburg and 
Kissingen ? 

The best time for taking the Harrogate waters is from 
May till the end of September. But patients may 
drink and also bathe at any season with advantage; 
Harrogate, however, is not a place for delicate people to 
go to in inclement weather. The great resort of visitors 
to Harrogate is, I believe, from the west of Scotland and 
north of Ireland. 

Bridge of Allan, near Stirling. — The sheltered situation 
of this place makes it a favourite resort for the people 
of Edinburgh and for others, who are glad to escape for 
a time the cold wind of the eastern coast It has a salt 
spring, which contains in the pint 47*5 grs. of common 
salt, 38*4 of muriate, and 4*15 of sulphate of lime; 
unfortunately the presence of nearly as much lime as 
of salt impedes the favourable action of the former. 
Nevertheless these waters are a good deal resorted to for 
affections of the digestive organs — certain forms of which 


are commonly supposed to be induced by whisky drinking 
and the use of oatmeal. The waters are aperient, and 
they are heated before they are drunk. Three tumblers 
before breakfast is the usual quantity. 

Bridge of Allan is a very pleasant health-resort, as 
are also the smaller places of Bridge of Earn and Inner- 
leithen, both having waters of the same nature with it, 
containing a good deal of common salt, along with 
muriate of lime. 



It is pretty certain that the fibrine and albumen of 
the blood are kept in a state of solution by the pre- 
sence of alkalies. Soda is the alkali the presence of 
which is most important in the human system — far 
more important than that of potash. It is found in 
the blood combined with chlorine, with phosphoric 
and carbonic acids. Most of the fluids of the body 
are indeed alkaline. The saliva is commonly so ; bile 
has a weak alkaline reaction ; the mucus of the whole 
intestinal canal is alkaline ; the urine in man is usually 
slightly acid, and it is one of the functions of the 
kidneys to remove excess of alkalies from the system. 
The physiological operation of the alkalies is very imper- 
fectly known. It is probable, although it is not proved, 
that alkalies accelerate, while acids retard oxidation. 
Two modes of the operation of alkalies are undoubted ; 
their chemical action on acids with which they come in 
contact in the system, and the fact that their presence 
is essential to the formation of bile. 


Large doses of alkalies readily make the urine alkaline, 
and it is believed render other fluids of the body so 
also. The salts of soda are diuretic; the carbonates 
more so than the chlorides. The carbonates and bi- 
carbonates act most directly on the system ; but all the 
combinations with vegetable acids are rapidly decom- 
posed in the stomach. It is only in small doses that alkalies 
assist digestion, and thereby the nutrition of the system ; 
in large doses they have been proved by experiments on 
animals to obstruct assimilation. There is no question 
that the continued use of large quantities of alkalies is 
very lowering to the system, mainly through altering the 
consistence of the blood, and making it more fluid. 

The theory of the use of alkaline waters has hitherto 
rested mainly on their chemical action on the fluids, their 
saturating acids, and their producing alkalisation ; grant- 
ing that there may be such a condition, will alkaline 
waters in the quantity that is usually drunk, induce it, and 
how long does it last, after their use has been given up ? 
This notion of counteracting acidity at once leads us to 
the digestive processes, and affections of the stomach. 

Dyspepsia, — There are no cases more likely to profit by 
a resort to a suitable spring than dyspeptic ones. The 
symptoms of this complaint (the disease indeed is in one 
sense only a symptom) need not be described here. 

But a state of things which often occurs in those who 
have resided long in the tropics, and have no organic 
disease, is this. There is a feeling of nausea on getting 


up in the morning, leading either to hawking up a little 
mucus, or sometimes to vomiting up the contents of the 
stomach. In such cases elongated uvula is very frequent, 
and by its irritation it keeps up a short cough. There is 
often also a relaxed state of the throat, and a granular 
state of the pharynx. The condition comes close to that 
of laryngo-pharyngitis, only the voice and larynx are not 
commonly affected. After regulation of the diet, which 
is a very important point, the use of an alkaline water 
will often aid to remove these symptoms of disturbed 

In functional diseases of the stomach generally, 
alkaline waters may be useful, first, in relieving 
acidity, and secondly, in influencing favourably the 
innervation and peristaltic action of the bowels. True 
mucous catarrh of the stomach — and writers are by no 
means agreed as to what constitutes this — generally 
requires some more powerful waters; when diarrhoea 
is mild enough to come under the designation of intes- 
tinal catarrh, small doses of the warm alkaline waters 
may be of use. 

Liver. — Whatever the specific action of soda in the 
secretion of bile may be, it is certain that enlargement 
of the liver often disappears under the employment 
of alkaline waters, though probably not so fast as under 
that of more purgative ones. 

However the desirable effect is produced, — and the 
emulgent effect of large quantities of water must help the 


passage of all stones, — I have known patients suffering 
fearfully from gall-stones recover their health completely 
by periodical visits to alkaline waters. No doubt assist- 
ing causes may be found in the facts, that the increased 
consumption of water favours the secretion of bile, and 
quickened action of the intestinal canal stimulates the 

There is no evidence that alkaline waters are of use 
in enlargements of the spleen. 

Diabetes.— On the idea that want of soda is the 
reason why sugar does not convert itself in the blood, 
soda was for a long time used in this complaint. The 
general conclusion arrived at concerning it seems to be 
this, that while continued long and given in large doses 
it is distinctly injurious, in smaller doses, again, it has 
often proved of positive, at least temporary benefit. 
This may arise either from a favourable action on the 
liver, disorder of which is at the root of diabetes, or from 
moderating the excessive secretion of acid common in 
diabetic patients. But whatever the theory of its opera- 
tion may be, most practical writers have recognised the 
usefulness of small doses of alkalies in diabetes. Vichy 
and Carlsbad waters have their rival advocates, and the 
effect of both depends mainly on the carbonate of soda 
which they contain. Various sagacious physicians have 
satisfied themselves that these waters, whether from their 
thermality or other cause, are more efficacious than the 
simple exhibition of carbonate of soda. It is, of course, 


only in the early stage and in the milder forms of the 
disease that a certain amount of benefit is to be expected. 

In lithiasisy or the tendency to form stone in the 
bladder, much was for a long time expected from the 
chemical action of waters ; but hopes have been disap- 
pointed. Miinch's experiments show, that although 
the use of carbonate of soda at first diminishes the 
quantity of lithic acid in the urine, this effect after a 
time disappears. When actual concretions have been 
formed in the bladder, it has never been known that they 
have been diminished in size or dissolved by alkaline 
waters ; nay, there is even some suspicion that the latter 
have sometimes led to the formation of them. 

Ample dilution with hot water is probably the secret 
of success in some cases of gravel, as also in vesical 
catarrh, and in affections of the kidneys, in which alkaline 
waters have been employed, in most of which cases the 
simultaneous action of baths on the skin is not to be over- 
looked. In such cases no doubt the actual alkalescence 
of the mineral waters helps, and the presence of a little 
common salt does not interfere with the alkaline action. 

In gout alkaline waters are often found very useful. 
They were given on the theory that they were to saturate 
lithic acid, which in cases of gout was supposed to be in 
excess in the system ; but the modern view is that there 
is a deficiency of lithic acid. The undoubted efficacy of 
such waters probably depends on their favouring retro- 
gressive changes and the absorption of fat ; as treatment 


by alkaline waters is essentially lowering) it is only in the 
more active forms of gout in the robust that these waters 
are indicated. 

Mucous Membranes, — It has long been known empi- 
rically that the use of alkalies tended to diminish ca- 
tarrhal discharges. This effect was produced, probably 
not, as was commonly thought, by the alkalies softening 
them, and making them thinner; but rather, while they 
diminished their quantity, by making them more consis- 
tent : and a recent theory has been propounded that 
alkaline solutions excite ciliary movements on mucous 
surfaces, and thus lead to altered action of them. 

Respiratory Organs. — Alkaline waters are accordingly 
often found useful in chronic bronchial catarrhs, and, 
as they are generally thermal ones, their warmth no 
doubt greatly facilitates expectoration. In the same 
way, in some forms of consumption connected with 
acidity of the stomach and impaired digestion, alkalies 
are often used with advantage, and we can understand 
how some of the alkaline waters abroad have obtained 
a reputation in incipient phthisis. They are also much 
used in all laryngeal affections, and in vesical catarrhs, as 
already mentioned. 

Diseases of Women. — Slight vaginal catarrh is often 
treated with alkaline waters, but more by their local use 
than by drinking. Such cases usually require treatment 
of a more tonic character. If an anaemic condition is 
present, they are contra-indicated. 



The number of powerful alkaline waters is not great 
In fact they are only drunk at a few sources, while there 
is an immense export of such waters. In examining the 
following table, it is to be recollected that they almost 
all contain more or less of common salt, and that the 
quantity of carbonic acid is stated variously by different 




of Soda. 



Chloride of 9*£°£, c 
*<>*-• 1nd£ 

Vichy . . 105 





Vals (about) — 





Neuenahr . 92 to 97 





Heilbrunnen — 

13 4 




Ems . . 85°to 115 

° 15 




Geilnau . . — 





Fachingen . — 





Giesshiibel . — 





Bilin. . . — 





Luhatschowitz — 





Gleichenberg — 





Ischia, C. . 95° 





Fideris . . — 





Bourboule,F. 89 





Royat . . 95° 





Vichy. — This is by far the first alkaline bath in Europe, 
and the greatest thermal establishment in France, over- 
crowded every season. It lies on the Allier, in a country 
not remarkable for beauty. There is a handsome casino. 


and abundance of hotels to suit all tastes. There are 
shady walks in front of the baths, and a pleasant piece 
of garden laid out on the banks of the river. The chief 
objection to the climate of the place is, that in the height 
of summer it is intensely hot — unbearable in July. I 
have not space to describe the baths in detail, or the 
manufactory of Vichy lozenges, or the arrangements for 
bottling and exporting the waters. There is a military 
hospital here. 

The wells are the Grande Grille, Puits Carre', Hopital, 
Celestins, de Mesdames, and some others. The general 
constitution of all the waters is alike, and they owe their 
virtues to the carbonic acid and carbonate of soda 
present, as appears from the analysis of two of them. 

The Grande Grille. 

The Hospital Well. 

Bicarbonate of Soda . . 

37 501 


„ „ Potass . . 



„ „ Magnesia . 



„ „ Lime . . 

3 33 


Sulphate of Soda . . . 



Chloride of Soda . . . 



And the first contains 6*973, the second 8*194 inches of 
carbonic acid gas in the pint. There are also minute 
quantities of phosphate of soda, arseniate of soda, of 
carbonates of strontium and of iron, to which it is im- 
possible to attach much significance, although the prac- 
titioners on the spot explain the varied operation of the 
waters according to their presence or absence. The 
quantity of water drunk is two to four and six glasses. 



The use of the baths is also commonly associated with 
drinking. Their average temperature is 90 to 91 , and 
patients stay in them twenty to forty minutes. 

The great majority of patients who resort hither, come 
for some urinary affection — gravel, catarrh of the bladder, 
diabetes ; many with stone already formed look for its 
solution, or at least for the prevention of further forma- 
tion of concretions. Cases of gout come in great num- 
bers, but it is only those whose constitution is not much 
weakened who are fit subjects for these waters; also 
cases of dyspepsia, of engorgement of the liver and 
spleen. Cases of the first kind benefit here, but spleen 
rarely or never ; in some cases of biliary calculi these 
waters work wonders. The Vichy waters diminish obesity, 
as doses of potass and other alkalies do, the theory being 
that the alkali combines with the fat and removes it as a 
sort of soap. Ladies also come here for many uterine 
affections, and the careful employment of the waters in 
drinking and in baths and douches is often of use. 

Vals, in Ardeche, west of the Lyons and Marseilles 
railway, has stronger carbonate of soda waters than 
Vichy ; they are cold, and for the present they are chiefly 
used for exportation. 

There is another spring in Vals called the Dominique, 
which is vaunted as infallible in paludal cachexias, spleen, 
and obstinate intermittent fevers ; how far there is ground 
for this, or whether those virtues necessarily result from 
the presence of a little arsenic, I cannot say. There 


seems to be accommodation for strangers, but no bath 

Vic sur Cere, in Cantal, in a strikingly picturesque 
country, comes next of French wells in the quantity of 
carbonate of soda; it contains about 15 grains in the 
pint, but with this are associated about 11 grains of 
common salt, and 7 or 8 of sulphate of soda, with 
minute quantities of iron and of arseniates, with quite as 
much carbonic acid as Vichy. These waters have risen 
into considerable importance of late years, owing to the 
varied nature of their constituents, the sulphate of soda 
giving them a slight resemblance to some of the Bohemian 
wells* They are lauded in urinary affections, congestion 
of the liver, and even in rebellious intermittents. 

Chaudes Aigues has weak alkaline springs, of a tempera- 
ture from 1 43 to 17 8°. It lies in Cantal, in a savage 
gorge which separates Auvergne from Gevaudan. Living 
is cheap enough, and the neighbourhood not without 
attractions, but the number of visitors is small. Like 
other very warm waters, these are used chiefly for 
rheumatism and enlargement of the joints. 

Mont Dork, one of the chief and best-managed esta- 
blishments in France, in the valley of the Dordogne, 
lies high up (3,300 feet) among the volcanic mountains 
of Auvergne, in a very interesting country. It has one 
cold and six thermal springs. They are feeble alkaline 
ones, the strongest not containing quite 5 grains of 
carbonate of soda in the' 16 ounces ;- temperature 90 

R 2 


to 104 . The waters are used for drinking, for baths, 
and for douches, and there are inhalation-rooms. July 
is the chief season, although the season extends from 
15 th June to 15 th September. 

It is especially in the treatment of chronic bronchitic 
attacks and in threatening of consumption that Mont 
Dord has its great reputation. Baths of a considerable 
temperature form the chief element of treatment; and 
if they are really useful, the question suggests itself, 
whether in our management of phthisis we usually pay 
sufficient attention to the condition of the skin ? whether 
the use of baths in the treatment of that disease is not 
too much overlooked? and this the more particularly, 
when phthisis is no longer regarded as the result of 
unavoidable hereditary inheritance, but often as the 
consequence of catarrhal pneumonia. 

Roy at, near Clermont, and on the road to Mont Dore', 
has alkaline waters of a temperature from 82 to 95 , rising 
abundantly in a gorge. It is about 1,400 feet above the 
sea, and its waters have been compared to those of Ems. 
The buildings are new, and the place has attractions. 

St. Nectaire, an older bath in the same district, with 
thermal waters purer and more alkaline than those of 
Royat, has several establishments. 

Soultzmatt, in an agreeable valley in the eastern part 
of the Vosges, has the advantage in mineral constituents 
over Vic and Mont Dore', containing about 9 grains of 
carbonate of soda, 3 of carbonate of magnesia, and 4 


of carbonate of lime, besides some 9 inches of carbonic 
acid gas, and an infinitesimal amount of boracic acid. 
The waters for the present are chiefly exported; they 
are indicated where weak alkaline waters are desired. 

Heilbrunnen, in the interesting volcanic valley of Brohl 
on the Rhine, deserves a notice here, owing to the unusual 
amount of magnesia which its waters contain. Their 
composition is : carbonate of soda 13*4, of magnesia 8*4, 
of lime 2*5, common salt 12*6, sulphate of soda 2*3, 
carbonate of iron *68, and no less than 43 inches of 
carbonic acid; for the present it is only exported, but 
taken in connexion with the pleasant acidulous Tonnistein 
spring close to it, and a strong chalybeate not far off, 
a future of some importance seems possible. There is 
a small bathing establishment, and grounds have been 
laid out for visitors.* 

Ems has been termed by a very critical German the 
pearl of baths, and an enthusiastic Frenchman has called 
it the violet ; we cannot therefore be very far wrong 
in considering it a desirable place — and a very pretty, 
picturesque spot it is ; its social attractions are thus 
described : " II y r&gne un esprit de bon ton, de dis- 
tinction parfaite, sans roideur, sans morgue aristocra- 

* The Brunnen and Bade Verwaltung of Brohl should learn to 
write less comical English. While telling us that " lovely nature far 
and near will make a stay at our place very pleasing," they mention 
that their waters are useful "in chronical blenorrhcea of the bronchial" 
artery, and that they cause a general laxativeness without colics." 


tique." Ems is so well known, that much need not 
be said of it Its gambling is comparatively quiet 

The waters are mild alkaline, and may be said to 
contain in the 16 ozs. 15 grs. of carbonate of soda, 7 grs. 
of common salt, 1*5 and 17 of carbonate of lime and of 
magnesia, with an abundant supply of carbonic acid— 
19 cubic inches. 

Two of the springs are used chiefly in drinking, — the 
Kraenchen, temp. 85 , and the Kesselbrunnen, 115 ; 
the others, and especially the Fiirstenbrunnen, 95 , and 
the new well, 117*5°, are employed for«baths, while the 
Bubenquelle, 104 , is used only for uterine douches, at 
a temperature of 90 . 

This is the most popular women's bath in Europe. It 
need scarcely be said that no waters cure sterility, while 
the careful use of douches of these mild alkaline waters 
may be useful in improving certain local conditions. 

On the whole, Ems is perhaps best suited for cases 
of bronchial and laryngeal catarrh, in whose favour 
is the mild and moderately moist climate of the place, 
which lies sheltered between high hills on the banks 
of the Lahn. 

All the public rooms are on a large scale, and there 
is abundant variety of amusements. 

There are carbonic gas inhalation-rooms here. Their 
success was once much puffed up, but they are falling 
into neglect. 

Neuenahr, in the valley of the Ahr, not far from the 


Rhine between Bonn and Coblentz, has of late years 
come into notice. It has new showy buildings. It 
is near the very interesting scenery of Altenahr, but 
for the present it wants shade ; it possesses feeble 
alkaline sources — the springs commonly used barely con- 
taining 6 grs. of carbonate of soda, with perhaps 2 grs. 
of carbonate of magnesia, and 1 J of carbonate of lime ; 
the most favourable analysis of some of the springs 
gives as much as 8*2, and even io*8, of carbonate of 
soda. The temperature, of the waters varies from 90*5° 
to about 105 ; and there is an abundant supply of car- 
bonic acid, from 17 to 32 inches. 

These waters have become very popular, and are 
much frequented for the same complaints as Ems. 
Thus they profess to be useful in pulmonary affections, 
even in phthisis and emphysema of the lungs, catarrh of 
the stomach and bladder, hypertrophy of the liver, uric 
acid diathesis, hysterical affections. No doubt these 
waters can effect anything to be fairly expected from 
warm carbonic acid waters with a little alkali, but it is 
difficult to assign them a place very different from the 
waters which have enjoyed the longest and most con- 
stant popularity, i.e. the indifferent thermal ones. There 
are baths, douches, and inhalation-rooms. 

Fachingeh, in the valley of the Lahn, and Bilin, near 
Teplitz, contain as much as 28 and 33 of carbonate of 
soda, and plenty of carbonic acid ; the waters are almost 
exclusively used for exportation, which is increasing. 


Gleuheribergy not many miles from Gratz in Styria, has 
a considerably more alkaline spring than Ems. The 
amount of carbonate of soda is variously stated at from 
20 to 27 grs., of common salt 14, with about 4 grs. of 
carbonate of magnesia, and also of lime. There is an 
abundant supply of carbonic acid. The climate is 
excellent and the whole district attractive. 

FideriSj weakest though it be of alkaline waters, de- 
serves notice because it was described 300 years ago 
by Conrad Gessner, and as it is in a district of Switzer- 
land to which the attention of the English has been 
drawn of late. It has a small establishment, but is always 
overcrowded with Swiss ; it is recommended for children 
and anaemic persons, in threatened tuberculosis, and 
especially in dyspepsia. 

Luhatschowitz, about ten miles from Hradisch, on the 
northern line of railway from Vienna, is the only alka- 
line bath at a considerable height, for Fideris can 
hardly be counted an alkaline well. It is about 1,700 
feet above the sea, in a pleasant valley among the 
Carpathian mountains. The climate is mild, and in- 
clined to be damp. The analysis of this water given 
above, shows that it is the strongest alkaline in Europe, 
while the quantity of common salt present is not suf- 
ficient to act as an aperient. The springs are used 
chiefly for drinking ; there is a ewe whey establishment 
here, but the place is too new to judge yet of its future. 
There are sixteen lodging-houses, and only one hotel. 



Some notion has already been given of the action of 
soda, magnesia, and of lime on the system, and waters 
containing those substances have, with the exception of 
chloride of sodium, been treated of as alkaline waters ; 
but many of these salts, especially soda and magnesia, 
often exist in combination with sulphuric acid, which 
imparts a new character, and so well marked a one, 
that they may be termed purging waters. They are a 
very important division of mineral waters, but of the 
nature of their operation, — as Liebig's views on the sub- 
ject, that they act by producing increased exosmosis, are 
not generally accepted, — very little is known beyond 
their mere aperient effects. Sulphates of soda and of 
magnesia in small doses cause diarrhoea ; in large ones 
(although when injected into the veins they do not appear 
to act in this way), catharsis. 

The sulphuric acid of the sulphates taken up by the 
stomach, is chiefly excreted again through the kidneys, 
and is found partially in other secretions. The greater 
part of the magnesia and soda probably leave the system 


unused. In the excretions produced by these salts, are 
found, besides water and the remains of food, bilious 
matters, some of the acids of digestion, and some 
remains of the salts themselves. These salts were not 
known to operate specially in any, way on the nervous 
system. Recent experiments, however, seem to show, 
that sulphate of magnesia in large . doses, though in a 
much less degree than sulphate of potass, acts on the 
muscular tissue as a poison, and through it on the 
respiration and the heart. Sulphate of soda can be 
given with safety in much larger doses than sulphate 
of magnesia. In small doses neither of them act as 
poisons; but a continued use of large quantities of 
earthy and of alkaline sulphates is injurious to the 
digestive organs. Indeed, there is evidence that sulphate 
of soda diminishes the coagulability of blood, and thus 
favours haemorrhage. 

Sulphated waters exist in a stronger form, when they 
are chiefly exported and used as a substitute for ordi- 
nary aperient medicine, and also in a weaker form, when 
considerable quantities of common salt and of carbonate 
of soda are usually present. 

The latter class of waters occurs at many of the more 
important spas, and their therapeutic actions are valuable. 
The quantity of purging salts present is, comparatively 
speaking, so small in most of them, that we must look 
to something more than their mere purging action to 
explain their beneficial effects. Their general operation 


has been thus described. They always produce a certain 
loss of substance to the system, chiefly at the expense 
of its fat, without the muscles bearing any share in 
it, and without impairing the appetite, the digestion, the 
general powers of assimilation, and the feeling of health. 
A lowering of the powers only results from the use 
of an excessive quantity of such waters. These waters 
are used most in abdominal disorders : 1. To improve 
digestion and the action of the bowels ; 2. in affections 
of the liver and spleen ; 3. the mild use of them is indi- 
cated in the same cases as that of the alkaline waters. 

German practitioners of the old school should find 
themselves in a paradise among wells of this description, 
the favourite cures for their ever-present idea, abdo- 
minal plethora, or venous dyscrasy. This term includes 
hypochondriasis and haemorrhoids, and many of the 
affections of middle age, supposed to be caused by 
indulgence in over-nutritious food and by sedentary 
habits, and which results in a disproportion between the 
power of the heart and the amount of blood to be pro- 
pelled, leading to retarded circulation, especially of the 
portal system. By their purgative action, the stronger of 
these waters derive from the head, and the deep-seated 
organs. Quickening the abdominal circulation, and 
regulating the peristaltic action of the bowels, they as it 
were lighten the system, and remove congestions. 

They are considered particularly useful in cases of 
haemorrhoidal congestion, bringing on crises in piles 


and restoring what many Germans seem to regard as a 
natural function. They are more useful in full-blooded, 
big-bellied, sanguine men, who are the better for getting 
rid of a portion of their superfluous fat — for that class 
of hemorrhoidal patients — than for the thinner, sallow- 
faced, yellow-conjunctivaed class, with low spirits and 
hypochondriasis, who of all things do not require further 
lowering treatment 

There can be no question that these waters are power 
ful agents in simple congestion and enlargement of the 
liver; that large livers diminish rapidly in bulk under 
their use. Such beneficial effects cannot, of course, be 
expected in cases of structural change, as in cirrhosis; 
and in suspicion of the presence of hepatic abscess, the 
use of such waters, owing to their lowering quality, must 
be worse than useless. 

It seems to be quite proved, that enlarged spleen is 
often reduced in size by the employment of these waters, 
aided by what is generally considered a very powerful ad- 
juvant in such cases, the peat-baths ; but although change 
of air, such as is got in travelling, is of much use in spleen 
disease, it is questionable, whether any bath treatment is 
nearly so effective as the ordinary treatment by steel 
medicines. It is worth observing, that a combination of 
the neutral salts and of iron has long been a popular 
remedy for spleen in India, and that some of those 
waters, which in addition contain steel, have a consider- 
able analogy to such a preparation. 


These waters are generally useful in the same catarrhal 
states in which the alkaline waters are found beneficial ; 
but their greater activity of operation must be borne in 
mind, and they are not in these cases so useful as the 
alkaline waters, while it seems probable that they are 
more active in gout and in lithiasis ; they also have some- 
times given encouragement in diabetes, and Carlsbad 
waters have been used nearly as much as Vichy ones in 
that condition of system in which there may be an ex- 
cessive production of glycose, an imperfect oxidation of 
it, or a combination of both conditions. Such waters are 
naturally most useful in cases in which the affection is 
the result of a sedentary life, and when more activity of 
the abdominal circulation is desired. 

We shall first consider the purging waters, which con- 
tain little or no carbonate of soda. 

The general composition of these purging waters 
will be best understood from the following rough 
table of their chief constituents. The last four differ 
from the others in containing a larger quantity of 
common salt, but they all are without carbonate of 

Sulphate Sulphate Chloride Chloride r__u • 

Of of of of a 'J 

Soda. Magnesia. Soda. Magnesia. Acia * 

Pttllna 123-8 93 116 16*6 6*9 

Seidlitz 17 104 3 — — 

Saidschiitz .... 46 84 2 25 (nitrate) 

Birmersdorf ... 154 169 — — — 

Epsom — 240 — — — 







Chloride Chloride Qajfoonj 
of of Acid 
Soda. Magnesia. 

Aranjuez .... 396 



— — 

Vacia, Madrid . . . 1296? 



— — 

Friederichshall ... 41 


6 7 

30 9 

Leamington ... 40*3 



— 2*1 

Cheltenham, Sulphur S. 29 



65 - 

Cheltenham, Strong S. 117 



— — 

St. Gervais .... 20 



— — 



— — 

Only the last four of these waters are drunk at their 
sources. The first are only exported — and they are 
simply to be regarded as convenient purgative waters. 
The two most popular, and which are most used all over 
Europe, are the Pullna and Friederichshall. Patients will 
take them more readily than similar preparations made 
at a chemist's, and I have known them used with great 
comfort in habitual constipation for considerable periods, 
apparently not losing their power, or acting injuriously 
in any way on the system. It may be observed that 
the common Seidlitz powder of potassio-tartrate and 
carbonate of soda, with tartaric acid, is not in the 
slightest degree analogous in composition to that of the 
waters, from which they derive their name. There is. 
however, no necessity for discussing here the operation 
of purgative waters not. drunk on the spot; and the 
original Epsom well, from which the salts have got their 
name, and which the people of London used to resort 
to, is now enclosed within a garden, and only a straj 


application is now and then made for permission to 
drink them. 

The four wells to be now noticed, have many analogies 
with the common salt ones, but they contain so much 
more of purging salts than salt springs usually do, that 
it has seemed convenient to notice them shortly by 

The baths of St Gervais lie in a valley about 2,000 
feet above the sea, not far from Chamounix, and there- 
fore in the centre of the most magnificent scenery in 

There are four principal springs, varying in temperature 
from 77 to 126 . One well contains about 20 grs. of 
common salt and 14 grs. of sulphate of soda, while 
another contains about 15 grs. of each of them, with 
the addition of 7 grs. of sulphate of lime. They also 
contain small amounts of hydrosulphuric acid and of 
iron. The baths can be used at the natural temperature 
of their waters. 

The waters, which when drunk are slightly aperient, 
are found to be useful in some eczemas, and eruptions 
depending on disorders of the digestion, in chronic 
bronchial catarrhs, and are reckoned especially efficacious 
in neuralgias, and in cases of head affection the result of 
over-work, in the production of which effects, doubtless 
the Alpine climate co-operates with the slight derivative 
action of the waters. There has been for a long time a 
large bathing establishment here, to which a hydro- 


pathic establishment has been lately added. Season, 
from i st June to 15th September. 

Uriage, in a pretty valley about 1,500 feet above the 
sea, not far from Grenoble, has its waters of the 
temperature of 79 , and, if the analysis of it can be 
trusted, one of the strongest salt waters in France, but 
it contains so much of purgative salts as to justify its 
being placed here. Its main constituents are common salt 
59 grs* sulphate of magnesia 19 grs., of soda 18 grs., 
carbonate of lime 15 grs., also some hydrosulphuric 

These waters are celebrated for the treatment of 
chronic affections of the skin, in which the use of the 
bath is the most important part of the treatment They 
are also much used in scrofula and in glandular enlarge- 
ments. If they had been in Germany, they would 
undoubtedly have been employed in congestion of the 
liver and sluggish states of the abdominal canal, for 
which they are particularly fitted. 

The arrangements here are excellent; it is a very 
picturesque part of France little known to English, but 
has many attractions, and there is a very considerable 
resort to these waters. 

Cheltenham, in the west of England, has quite fallen 
from its high estate; from being a crowded bath with 
12,000 or 15,000 visitors .annually, it has dropped into 
comparative neglect An analysis of two of the nine 
principal sources has been already given. The strong 


saline, owing to the quantity of common salt that it 
contains, has many points of analogy with Uriage, 
while the sulphur saline is more akin to St. Gervais. 

It is evident that the effects of the waters must vary a 
good deal according as the large quantity of common 
salt is taken or not. The waters are used chiefly in 
drinking. They were much used for the livers of old 
Indians in dyspepsia, and also in chlorosis and anaemia, 
and there is no reason why these waters, if used 
judiciously, should not be found efficient. What used 
to be sold as Cheltenham salts contained a good deal 
more of sulphate of soda than the natural waters. 

Leamington, in Warwickshire. — This well-known agree- 
able place of residence, according to the analysis of its 
waters already given, has points of analogy with one of 
the Cheltenham and with one of the St. Gervais wells, 
particularly the one of the latter which contains a good 
deal of lime, but it is more distinctly purgative than 
either. Here, as at Cheltenham, the public arrangements 
are excellent, and the waters are found useful in dys- 
pepsia and affections of the liver. 

Scarborough. — The strong sulphate of magnesia wells 
of this place have that salt so nearly equally balanced 
with sulphate and carbonate of lime, that they must lie 
heavy on the stomach; owing to their containing a 
small quantity of iron, they have been considered to be 

The next group of purging waters, though a small, is 


a 5 8 


a very important one. Their action is a good deal modi- 
fied by even the small quantity of carbonate of soda 
which they contain; one of them only is thermal- 
Carlsbad. The four, although one is in Saxony, are 
in the same district, and may be grouped as the Bohemian 
baths. Tarasp in the Lower Engadine is distinguished 
from them by the larger quantity both of carbonate of 
soda and of common salt which it contains. Possibly 
the late analysis of the waters of Ischia, or of some 
others in the Bay of Naples, may show that some of them 
are analogous to Tarasp. 


Carbonate Carbonate 
of of 
Soda. Magnesia. 


Sulphate CgMk 
Soda. Acid 

Carlsbad . . 124 




17 17 

Marienbad . — 




38 22 

Franzensbad . — 




25 31 

Elster ... — 




22 28 

Tarasp ... — 




16 33 

Rohitsch . . — 




IS 25 | 

Bourboule, G. S. — 




14 abundant 

Carlsbad is in many respects the most striking bath in 
Europe, as it is one of the most frequented. 

The mass of steaming water of the Sprudel, and 
the strange site among overhanging rocks selected for 
the place, at once arrest attention ; and on closer inves- 
tigation the waters are found to be among the most 
powerful in use, not waters with which you may trifle with 
impunity. Although in the height of summer the plau 


becomes intensely hot, there are sudden alternations of 

The walks in all directions among the woods are 
beautiful, and the views varied, but the hills are 
steep, and many invalids are unable to ascend them 
on foot 

The hotels are comfortable, but not of the latest 
fashion, and there are no tables <Thbte here, so that 
although there is an immense concourse of visitors at 
the baths, they are not particular favourites with the 
English. There is a look of dampness and want of 
repair about many of the buildings over the wells, 
though a magnificent new bathing establishment has 
lately been completed at the expense of the munici- 

The three chief of the eight wells — the Sprudel, Miihl- 
brunnen, and Schlossbrunnen — agree with each other in 
chemical composition in all essentials. They contain 
about i8grs. of sulphate of soda, iogrs. of carbonate of 
soda, 8 grs. of common salt, 2 or 3 grs. of carbonate of 
lime, and some unimportant salts. They are in tempera- 
ture 165 , 126 , 125 . The water of the Miihlbrunnen is 
commonly best borne by the stomach. The dose is two 
to six glasses daily, sometimes increased to eight and 
ten, and even more. The amount of water drunk should 
be diminished, whenever there is a tendency to watery 
dejections ; and that this is the first palpable operation 
of the waters, is very plain from the number of cabinets 

s 2 


scattered among the woods, and which diffuse an odour 
that calls loudly for hygienic measures. 

In former times these waters were used chiefly for 
bathing ; but now baths are the least important part of 
the cure. Stories of these waters producing peculiar 
electrical states of the system must be received with 
caution. Practitioners on the spot detect different 
operations of the different wells, although their chemical 
constitution is nearly uniform. 

These waters are the great remedy for enlarged and 
fatty livers. They seem also, like the waters of Vichy, 
to have certain virtues in gall-stones, the rationale of 
which it is not easy to explain. They are also used in 
many of the other complaints for which Vichy is em- 
ployed. When active effects on the abdominal viscera 
are wanted, Carlsbad is best. Where there are urinary 
complications Vichy is to be preferred. 

The peat baths are here, as in all the Bohemian 
baths, used very much, so that a portion of the good 
effects produced must be attributed to thermal action. 

The waters of Otto's Cave at Giesshiibel are acidulous 
and pleasant to the taste. A public conveyance plies to 
them. They have been long known, and are chiefly 
used for exportation, and that to a large extent. Carls- 
bad lies about 1,000 feet above the sea. Eger is for 
the present the nearest railway station, and it is about 
six hours' drive from that place ; but a railway will soon 
reach Carlsbad. 


Marienbad, if not so striking as Carlsbad, is 
much opener and less shut in, and it is beautifully 
situated in an amphitheatre of wooded hills. It is in 
all its arrangements the pleasantest of the quiet baths 
of Germany; but owing, I suppose, to the more 
powerful action of its waters, the remark made respecting 
the sanitary improvement required at Carlsbad, is still 
more applicable here. 

The wells of Marienbad differ from those of 
Carlsbad in being cold, and containing about double 
the quantity of purgative salts. Their composition is : 
sulphate of soda, 38 grs. ; common salt, 13 or 14 grs. ; car- 
bonate of soda, 9 grs. ; carbonates of lime and magnesia, 
each about 4 grs., with the important addition of from 
0*27 to 0-47 of oxide of iron, and 15 to 22 inches of 
carbonic gas. There is little to be said specially of these 
waters, except that they contain more iron than those 
of Carlsbad, and that if not used too actively, so as to 
cause violent purgation, it is probable that a portion of 
the iron is absorbed. There is also a very pleasant 
mild spring, the Wildbrunn. The presence of iron 
wells without purging salts is a great convenience ; and 
one of these, an earthy one, the Wiesen quelle, has of late 
been found useful in urinary affections. 

Peat baths form a still more essential part of treat- 
ment here than in Carlsbad, as the waters are cold. 

At Marienbad all the springs are conveniently situated 
in one line, and a patient may walk either down below, 


or take moderate walks on the hills, without requiring to * 
be able to climb, which is almost necessary at Carlsbad. 
On the whole I know no bath that ought to present 
more attractions to the English. Marienbad lies nearly 
2,000 feet above the sea, and is reached in five hours 
by coach from Eger. 

Franzmsbad lies in an ugly, uninteresting moor near 
the gloomy town of Eger, but everything has been done 
in the way of planting parks, in public institutions, and 
in good hotels to make up for its natural wants. It 
is greatly resorted to, and the patients, many of 
them chlorotic girls and pale-faced women, have a 
great look of business about them. They have come 
for cure, not for amusement. The number of English 
must be very small. 

The waters are cold, and in strength are between 
those of Marienbad and Carlsbad. The constituents 
of the Wiesenquelle and of the Sprudel are pretty nearly 
the same : about 26 grs. sulphate of soda ; 9 of common 
salt ; bicarbonate of soda, 6 or 7 grs. ; carbonate of iron, 
0-37 and o'2, with an immense supply, 30 to 40 inches, 
of carbonic gas. Their operation is the same as that 
of other waters of this group. 

Peat baths here, too, are in constant use. Franzens- 
bad is now reached very easily, as it is a station on 
the Eger railway. 

Elster, though comparatively a small bath, has great 
advantages over Franzensbad in lying in a pleasant 


valley, 1,460 feet above the sea. It has scarcely been 
found out by the English yet. The Government of 
Saxony, or rather its king, has done a great deal for 
the place ; and as Saxony is not rich in mineral waters, 
good subjects of King John are expected to make the 
most of Elster. The bath establishment is good. 

Although it contains one very strong sulphate of soda 
well, the amount of salts present on an average resembles 
that of Carlsbad, Franzensbad, or Marienbad. The 
constituents are : sulphate of soda, 22 grs. ; common salt, 
14 grs.; carbonate of soda, 4 grs. ; with 16 to 28 inches of 
carbonic acid gas ; but it is distinguished from the other 
group by having much stronger chalybeates. 

The same effects can be produced at Marienbad, 
Franzensbad, and Elster, but of the three the most 
attractive are. the first and last. There are a good 
many points of resemblance between Elster and 
Schwalbach, and it deserves to be more visited. The 
living is very moderate, and there are plenty of good 
lodging-houses. It is about a couple of miles from the 
nearest railway station. It has peat baths, and a whey 
cure also. 

Bourboule, a short way from Mont Dore*, in a pic- 
turesque country at the foot of an enormous granite 
rock, and at a height of 2,748 feet, contains two springs, 
having such constituents that it is surprising that the 
accommodation suited for visitors, except country people, 
has not yet been provided. 


These springs have many points of analogy with those 

of Tarasp, especially the second one, which contains as 

much as 13*5 grs. of sulphate of soda. The springs range 

in temperature from 87 to 11 8°. These waters have 

been called analogous to those of Mont Dore', but they 

are much more powerful. They are strongly alterative, 

and ought to be useful in congestion of liver, and in 

such cases as the waters of Kissingen and of some of 

the Bohemian spas. 

Rohitsch, not far from Cilli, in that pleasant corner 
of the world, Styria, deserves a passing notice, though 
its arrangements are still on a small scale. Its waters, 
well suited for dyspepsia, are drunk by some thousands 
on the spot, and are exported largely. The place is 
little known to the English, but the neighbourhood is 
pleasant and the climate excellent. 

Tarasp, in 'the Lower Engadine, which may be 
reached either by coming down from St. Moritz, or by 
going up from Finstermiintz, about 4,000 feet above 
the sea, has of late years, along with the neighbouring 
Schtds and Vulpera, been growing much in importance. 
Its wells had indeed been known for centuries, but 
had not attracted sufficient attention. 

Its water differs materially from the wells just men- 
tioned, in containing nearly twice as much carbonate 
of soda and common salt as it does of the purging 
sulphate of soda ; it has also an appreciable quantity 
of iron, and abundance, some 33 inches, of carbonic 


acid. In the neighbourhood also are a group of distinct 
chalybeates, and of sulphur wells. 

The waters are mainly employed for drinking, but 
there are also bathing arrangements. Patients begin 
with three glasses of 3 ozs. each, and go on gradually 
to six or eight glasses; usually within half an hour 
of taking the last glass the bowels are freely moved 
cwo or three times, and their operation on them is 
over, but there is increased secretion of urine in the 
afternoon and evening. Tarasp has only of late years 
come into notice, so that its effects have not been 
sufficiently studied; meantime its chief applications 
are considered to be in enlarged liver and spleen, 
catarrh of the stomach, general obesity, besides a great 
many other affections, among which chronic bronchial 
catarrhs and laryngitis hold the first place. They 
consider the waters contra-indicated in tuberculosis. 

Great efforts have been made to afford accommoda- 
tion for visitors, and there is a handsome bath estab- 
lishment. The climate of the Lower Engadine is much 
milder than that of the Upper, and the whole surrounding 
country is on a grand scale, and in many ways interesting 
to naturalists. Tarasp has a great future before it, when 
it becomes more accessible. 



Of late years the prevailing medical treatment in Europe 
has been what the French call reconstituent, the prin- 
ciples of which were foreshadowed by Toinette in the 
" Malade Imaginaire :" " II faut boire votre vin pur et 
pour epaissir votre sang qui est trop subtile, il faut manger 
de bon gros boeuf." In such treatment iron takes a very 
prominent place. 

Iron has long been popular as a tonic medicine. What 
could be more bracing than the martial preparations 
of steel and iron? When modern chemistry came to 
show that iron was actually present in the haematine of 
the blood, its use became still more extended ; poor 
blood is caused by want of iron, and therefore can be 
remedied by a supply of it. Those are the obvious ideas 
that suggest themselves, and if such could always be 
carried out, there would be more of precision in medi- 
cine, than we have yet arrived at. But it is not so easy 
always to make the system take up the substance which 
may seem chemically to be wanting, and iron is no ex- 
ception to the rule ; only small doses of iron are taken 


up by the blood — it declines to have large ones forced 
on it. 

Iron exists in blood united with its colouring matter. 
It has been calculated that the blood of a healthy man 
contains from about 37 to 47 grs. of it; iron is also 
found in other parts of the body, as in the muscles, 
and especially in the hair and in the spleen. It occurs 
in minute quantities in some of the secretions, including 
those of the alimentary canal. Iron is introduced into 
the system in articles of diet, and the proportion taken 
up depends mainly on the activity of the nutritive pro- 
cess; hence arises one of the questions regarding its 
administration, already hinted at, when noticing salt 
springs, whether in a particular case it is better to 
present iron directly to the stomach, or to endeavour 
to place the system in a condition favourable to its 
taking up iron from the food. 

The exact use of iron in the system is only partially 
known, although its presence appears to be essential 
to the formation of blood-globules. We know indeed 
that poverty of iron in the blood may be induced by 
excessive loss of the circulating fluid, or by continued 
suppuration or other discharges, and that there is a want 
of iron in the blood of girls suffering under that disease 
of imperfect development, chlorosis. 

A great deal of the iron which is exhibited medicinally 
is not absorbed, but passes off chiefly in the form of 
sulphates. Strong doses, especially of the sulphates, are 


— — 1 ■ ■■!■■■! ■! I 11^ ^— W • "■ ™" 

difficult of digestion, and thus some of the strongest 
chalybeate springs, for instance some English and Scotch 
ones — as Sandrock in the Isle of Wight, and Hartfell,— 
are practically useless. The oxides appear to be dis- 
solved by the gastric juice, and the presence of albumen 
and of phosphated alkalies favours solution; but even 
when introduced in a soluble state, iron is taken up very 
slowly. It seems to be taken up chiefly by the blood, 
not by the lymphatics. Part goes to the blood-corpuscles, 
part to the secretions and other parts of the system, 
especially the hair. Iron passes readily into the water, 
when more has been absorbed than is wanted by the 
system ; it has also been found in the perspiration and 
in bile. 

But a small quantity of iron appears ever to be 
absorbed ; it has been calculated that chlorotic patients 
have taken up 4 to 5 grs. of the lactate daily, or scarcely 
1 gr. of metallic iron. 

As to the physiological effects of iron when it is 
absorbed, it seems to make the pulse somewhat slower, 
and to have a contractile effect on the capillaries, and 
undoubtedly to cause a great increase of the blood- 
corpuscles; it is probable that it favours oxidation 
and the production of heat. Its continued use is said 
to lead to congestions, at the same time that its external 
and local application is strongly styptic, and its internal 
use often stops haemorrhages and other discharges. If 
presented in an unsuitable way to the stomach, it often 


interferes with healthy digestion ; on the whole it is 
constipating to people in health ; but some of its salts 
may cause diarrhoea in irritable states of the alimentary 

The medical uses of iron may be classified — first, 
according to its contractile action ; secondly, its general 
constitutional effects. In the first case it may be useful 
in chronic diarrhoeas and in atonic bronchial secretions ; 
it is much used in excessive secretion of the genito- 
urinary organs. It is also, by its contractile power on 
the blood-vessels, that its undoubted efficacy in spleen 
is supposed by many to be exercised. But its far more 
important effects, and those having most analogy with 
the effect of mineral waters, are its general and consti- 
tutional ones. 

Iron is of great service in cases of what may be called 
atrophy of the blood, want of red corpuscles and 
relative wateriness, whether the result of great losses 
by bleeding, suppuration, acute illnesses, or of a more 
gradual deterioration of system. The first class of cases 
improves very rapidly under iron; the other general 
cachexy cannot be so speedily removed. One of the 
most marked forms is the malarious one with enlarged 
spleen, not uncommon in Europe, but commoner in 
tropical countries ; such general conditions, where the 
liver and alimentary canal are in fair working order, may 
profit much by iron. Iron is the great remedy for 
spleen — it has also been said to cure intermittent fever ; 


and Pyrmont and some other spas are reported to have 
extinguished obstinate agues. 

But the disease of all others in which iron is con- 
sidered the remedy, is chlorosis; and in it, especially 
when combined with the stimulating effects of carbonic 
acid, it is most efficacious. It is scarcely necessary to 
define chlorosis ; the pale, sallow, bloodless look of some 
growing girls is familiar to all, and is to be cured by a 
combination of nourishment, exercise, and iron, with in 
some cases, when the bowels are sluggish, the addition 
of aperients ; it is in these last cases that the waters of 
Homburg and Franzensbad or Elster are preferable to 
simple chalybeates, when it is desirable to act a litde on 
the bowels. There is a somewhat similar condition in 
young men, accompanied with want of power, and in it 
also iron is one of our best remedies. It has been in- 
geniously calculated that for the cure of a case of chlo- 
rosis about twenty-two to forty-four grains of metallic 
iron are required, and a cure by mineral waters may 
be expected to extend over from four to six weeks. 

There are very few iron waters, indeed, in which the 
patient is able to take one grain of iron daily. 

Other classes of disease, such as neuralgias, hyperaes- 
thesias, impotence and sterility, have often come under 
treatment by iron ; but it is only in the two last, that 
some benefit may be expected from iron waters, and then 
not from any specific action, but from their general effect 
on the system. 


Every water that deposits a yellowish rust has 
been set down as a chalybeate, and the number 
of such springs in almost every country is infinite, 
not so the number of really powerful waters. They 
are very abundant in Northern Germany, scarce 
in England and in France. Italy has a few, and 
Spain appears to have some that enjoy considerable 

Iron occurs in waters mainly in the shape of carbon- 
ates, the most convenient form for its assimilation. Sul- 
phates, and still more chlorides, are uncommon, and iron 
rarely occurs in a water except with other salts. In all the 
popular spas there is an abundant supply of carbonic 
acid, which makes these wells palatable; but besides 
carbonic acid other substances are often present, and 
waters have been classified, according as various sub- 
stances predominate. For practical purposes they have 
been divided into tolerably pure, common salt, and com- 
plicated ones ; the last, besides some carbonate of soda, 
may contain Glauber salts, carbonate of magnesia or of 
lime, sulphate of magnesia or gypsum. 

There are few waters of which it is possible for a 
patient to take more than sixteen ounces, which may 
contain half a grain of iron. But if their analyses be 
correct, it might be possible to give more iron, by using 
such wells as Arapatak and the strong Harrogate. 
Many chalybeate waters are, as appears from the 
following table, at least 900 feet above the sea, which 



adds very materially to their effect They vary in tem- 
perature from about 39 to 62 or 63 . 

St. Moritz . . . 


Alexisbad . . 

- i,35<> 

St Bernardhine 



• 1,293 

Wyh, Schuls . . 


Petersthal . . 

. 1,100 

Rippoldsau . . . 


Spa .... 


Bagneres de Bigorres 


Schwalbach . . 


Reinerz .... 


Driberg . . . 



Booklet . . . 


Recoaro .... 







of Iron. 



Fachingen . . 

. O'll 

- • 38*3 • 

• - 32*4 

Giesshubel . . 

• o*33 . 

. . I2"2 . 

• • 39 

Geilnau . . . 

0-29 . 

. . i6*6 . 

. . 21 


. 0-18 . 

. . 275 . 

. . 22 

Heilbrunnen, B. 

. o-68 . 

. . 41*2 . 

• • 43 




Marienbad . . 

. C65 . 

. . 81 -5 . 

. . 148 

Franzensbad . . 

• 0'37 . 

. . 451 . 

• . 3i 

Elster .... 

0-48 . 


• • 33 



Kissingen . . 

. 0-24 . 

. . 657 . . 

. . 41 

Soden . . . 

. 0'2I 

. . 894 . . 

. 18 

Canstatt . . . 

. O25 . 

. . 40 

• 19 5 

Kreutznach . . 

. 0'2I . 

• • 79*3 - ■ 

. — 

Homburg . . 

. 0*I79 . 

. . 726 . . 

• 47 

Do. Lu. 

• 0"33 - 

. . 23-8 . . 


Harrogate, K. . 

• 0'373 • 

. . 1134 • • 

• 3 





Carbonate Mineral 


of Iron. Constituents. 


Orezza (about) 

. . o*8 ... 14 . . 


Pyrmont . . 

. . 0*42 . . 

. 17*9 . . 

. 18 

Driberg . . 

. . 0*78 . . 

. 38-5 • • 

. 28 

Petersthal . 

. . 035 . 

23*7 . . 

• 33 

Rippoldsau . 

. . 038 . 

. 231 . . 


Booklet . . 

. . 0*67 . 

. 286 . . 

- 39 

Bagneres de Bigorres 0*675 • ■ 

22*3 . . 

■ — 

St, Moritz . 

. . 0*18 * 

II • . 

■ 3i 


. . 0*25 . . 

■ 13*4 • • 

• 57 

Tarasp, B. . 

. . 0*25 . 

. 283 . . 

. 62 

Do. W. . 

107 . . 

. 48 

Wildungen . 

. . o*i6 . . 

11 . . 

■ 19 


Recoaro . . 

. . 0*29 ... 6*8 . . 


Schwalbach . 

• • 0*44 . 

11*9 . . 

• 45 


. . 0*64 . 

4'6 . . . 


Spa . . . 

• • °*37 

. 4*3 • • 


Liebenstein . 

• • 0-54 

107 . . 

• 32 

Briickenau . 

. . 0*092 

. 3*4 .. . 


Marienbad . 

• • °'33 

6*o . . . 


Tunbridge . 

. . 0*39 . 

i*o . . . 


Harrogate, T. 

. . 0*169 • 

x-3 - . . 


Alexisbad (sulph.) . 0*403 

. 36 . . . 



Wassenach . . . 3*08 . . . 12*9 . 

Arapatak ... 2*35 .. . 24*5 . 

Harrogate . . . 3'38( r8 chloride) 58*1. 

St. Bernardhine . 1*45 ... 24 


Perhaps no bath in Europe has kept up its reputation 
more steadily than Spa, and it has everything to justify 



this : good waters, agreeable country, excellent arrange- 
ments, and plenty of amusement, including the gambling 


rooms, which might be dispensed with. It is also of 
all baths the one most easily reached from England. 

Only one of the four or five abundant springs is in 
Spa itself, the others are at considerable distances in the 
woods. The water is very easily borne by most stomachs, 
and the quantity is from two to four glasses. It has been 
more used for baths of late years, and there is a mag- 
nificent bath-house. When baths are used, the higher 
temperatures are not recommended. Peat baths are to 
be had here, and chemical analysis has of course dis- 
covered that the peat soil of Spa contains particularly 
valuable principles. 

The waters of Spa are adapted most for anaemia and 
cachectic conditions of the system. The waters are not 
quite so strong as those of Schwalbach, but the general 
indications for the use of both are the same. Schwalbach 
has the advantage of stimulating the cutaneous functions 
more by its baths. 

The country around Spa is pretty, and there is no 
station where riding on horseback is so much practised. 
To the older arrangements of this long-established spa 
a very complete kur-haus has of late years been added. 

Pyrtnont, though with much to render it attractive, has 
rather gone down in the world of late ; but it lies in a 
beautiful valley, has excellent arrangements of all kinds, 
and can still boast of a gambling-table, a source of 


income to the Prince of Waldeck, in whose territory 
it is. 

There is an immense supply of carbonic acid in these 
springs, and some of them are said to have the stimu- 
lating effects of champagne. Patients begin with small 
quantities, two or three half or full glasses, and then 
go on gradually to six or eight 

Poverty of blood, hysteria, slow convalescence, hypo- 
chondriasis, are among the maladies likely to profit by 
Pyrmont, and the strong brine spring and salt drinking 
well vary the resources of the place. It is only 400 feet 
above the sea, and therefore cannot boast of Alpine 
climate, one of the most important adjuncts of some of 
the chalybeates now enjoying the greatest popularity. 
It requires four hours' driving to reach it from the 
nearest railway station. 

Alexisbad lies in the romantic Selke valley in Anhalt, 
about 1,400 feet above the sea. It has two iron wells : 
one the Selkebrunnen, used almost entirely for bathing; 
the other the Alexisbrunnen, for drinking. Its artificially- 
heated baths have gained a considerable reputation, 
especially in some of the affections of women connected], 
with a relaxed state of system, but it has no special 
virtues in this way ; though popular in the north of Ger- 
many, this bath is little known to the English. It is 
two to three hours' drive from the railway station of 

Driberg) in a pretty valley in Westphalia, has long 

t 2 


been popular among Germans, though not much visited 
by English. It is nearly 700 feet above the sea, and the 
air is counted pure and invigorating; three to eight 
glasses are the quantity usually drunk. Baths are also 
much used. An omnibus goes from the railway station 
to it. 

Liebenstein is a very quiet little place in Saxe Mein- 
ingen, but with a powerful spring ; it is more 'than 
900 feet above the sea. It has got a whey cure, a 
hydropathic establishment, and salt baths, and is in 
favour with the Northern Germans as a healthy place, 
where living is cheap. A pretty spot like this in the 
Thuringian Forest ought to suit many English people. It 
is less than an hour from the railway. 

Bruckenau. — It is a great pity that this seconded 
village, lying among hills covered with luxuriant forests 
of beech, and with admirable bath arrangements, cannot 
boast of a stronger well — its own not containing quite 
T^th of a grain of iron in the pint There are, however, 
some very pleasant acidulous springs useful in dyspepsia, 
and the turf baths are in full force. It is some hours' 
drive from Kissingen, and from the nearest railway 
station. This pretty spot was the favourite bath of 
the late King Louis of Bavaria, who built a handsome ' 
kur-haus, but without his patronage it must soon cease 
to be visited by those who are in need of vigorous 
treatment. The living is simple, but comfortable, and 
very cheap. 


Bocklet — In strong contrast to Bruckenau stands this 
place, not with the same natural and acquired advan- 
tages, although a pleasant enough place, but with a far 
more powerful, though not so pure a well. It is a dis- 
advantage to Bocklet that it is so close to Kissingen. 
Its waters come very well after a course of Kissingen, 
and there are carbonic acid douches for such as want 
them ; but visitors usually prefer a greater change than 
the mere move of some four or five miles up the same 
valley* However, Kissingen is often so overcrowded, 
that many patients are obliged to resort to Bocklet. 

Schwalbach is at this moment the most popular chaly- 
beate in Europe, and with very good reason. It has a 
good supply of iron, and an abundant one of carbonic 
acid ; and the presence of carbonic acid in considerable 
quantities has been secured for baths. By good arrange- 
ments only a small portion of the carbonic acid is lost in 
the process of heating, so that, although they are not to 
be compared with the stronger baths of this kind, the 
Schwalbach baths decidedly stimulate the skin, and are 
much liked by patients. Everything that has been said 
of the effects of iron applies to Schwalbach, and there 
are few wells which answer in their effects to one's 
expectations better than these. 

Schwalbach lies in a pretty valley surrounded by 
wooded hills, in which there are pleasant walks. But 
there is a want of public gardens sufficiently large for 
the recreation of the immense crowd of visitors, and the 


place gives a cramped feeling. The living too is on the 
whole not equal to what it is in many other places. The 
place is at times intensely hot The drive to Schlangen- 
bad is pleasant, and that place might be made more use 
of as a change than it is. English and Americans and 
other foreigners here greatly predominate in numbers 
over the Germans. It is reached by carriage in three 
hours from Wiesbaden, or from Eltville on the Rhine 

Rippoldsau y in the Black Forest, is growing into a fa- 
vourite station, and so is Petersthal. The amount of iron 
and of saline constituents that they contain, is nearly 
identical. For those who are satisfied with a plain way 
of living at a moderate cost, these, especially Rippoldsau, 
and other places in the Black Forest, offer many attrac- 
tions. The scenery is always pleasing, though sometimes 
a little monotonous, and the people are friendly. Rip- 
poldsau, at an elevation of about 1,900 feet, has the 
advantage of being 700 feet higher than Petersthal. 
They are easily reached by the Baden railways. 

St. Moritz, the most popular bath in Europe with the 
English at this moment, owes more to its elevation and 
to the quantity of carbonic acid it contains, than to its 
very moderate amount of iron. It has grown into notice 
with great rapidity. A few years ago the author of 
" Voyages des Zig-Zag" mentioned it in these disparaging 
terms. He talks of its woods which grow up the hills 
to the height of 700 feet above it, as contrasting 


" tristement presque avec les gracieuses scenes " which 
he had just left. Nor does he give a flattering account 
of the neighbouring village : " C'est une petite bourgade 
composee d'&ables et de cafe's billards, ou des baigneurs 
barbus tuent le temps: un de ces endroits qui doivent 
au sepur momentane* des malingres un peu de fausse 
vie, beaucoup d'odeur des cigarres et ce grotesque 
melange de patres occupe's et de messieurs faineants 
de liquoristes et de faiseurs de fromage, de laitage, de 
caiambolle. On nous recoit dans une salle de billard : 
on nous y loge dans un cafe*." Times have changed 
in these few years, and the crowd of visitors is so great 
that there is difficulty in getting accommodation. 

The mineral wells rise in a low meadow, somewhat 
marshy, where the baths are. They are used chiefly 
for drinking, but they are also heated for baths, and 
the carbonic acid gas is used for inhalations and local 
douches. As might be expected, waters slightly chaly- 
beate, and with abundance of carbonic acid gas, and 
therefore pleasant to drink, and having none of the 
after-effects of most medicines, are universally popular, 
and, in conjunction with the influence of the Alpine 
climate, are applicable to a variety of general condi- 
tions of debility and relaxation, among which chlorosis 
and anaemia are pre-eminent 

Besides its other attractions, St. Moritz is not far 
removed from many important wells of a variety of 
kinds : the alkalo-saline wells of Tarasp and Wyh^ in 


the Lower Engadine, both containing as much iron 
as St. Moritz; the steel waters of St Bcrnardhine, 
which must be very powerful, if the analysis of them 
is at all trustworthy, where baths have been built of 
late years in a very grand country ; the sulphur waters 
of Le Prese, on the way to Italy ; the indifferent baths 
of Pfeffers, and the earthy ones of Bormio, not to 
mention many less important ones springing into use, as 
those of Alveneu and Fideris. 

Excursions of the most varied kinds can be taken, and 
in fine weather the place is delightful, and the climate is 
quite exhilarating; but it must be recollected that the 
season is not a long one, and that although people, in 
spite of scanty supplies, are now wintering there for con- 
sumption, the saying of the country is, " Engadina terra 
fina, si non fosse la pruina." When there is difficulty in 
getting rooms at St. Moritz, it is best to push on to 
Silva Plana, Samaden, or other villages with very fair 
inns, and particularly to Pontresina, and wait till you 
get rooms ; you have all the advantage of the mountain 
climate there, and at some of them have much finer 
scenery than at St Moritz, especially at Pontresina. 
The living at St. Moritz is indifferent. 

Before leaving St Moritz, on which I have dwelt per- 
haps too long, owing to its present great popularity, I 
may observe that Paracelsus is commonly quoted as 
saying that St Moritz in the Grisons has the best well in 
Europe, and that its virtues are most powerful in the 


month of August I have only been able to discover 
in his works the vague statement, that there is an 
acidulous spring in the Grisons nobler than that of 
Goppingen (now forgotten), which it well may be, and 
that it owes a part of its virtues to the waters having 
passed through many cataracts. The excellence of the 
whisky produced at a celebrated distillery in Scotland 
has been attributed to a similar cause ! 

It still takes about eleven hours to reach St. Moritz by 
diligence from Chur on the railway. 

Recoaro is reached by diligence from Vicenza in about 
four hours. It is situated on the Prekeli, in a fine valley 
shut in by magnificent dolomite mountains. It is about 
1,500 feet above the sea. The arrangements of the place 
are excellent, and living is moderate. The place is high 
enough to escape to a considerable extent the heat of 
an Italian summer. Altogether, there is scarcely any 
other steel spring with a moderate amount of iron,— and 
it contains more than St Moritz, that offers so many 

I shall only mention one Spanish chalybeate. 
StaAgueda, about twelve miles from Alzola, and one of 
the group of northern Spanish baths near San Sebastian, 
besides its sulphur springs has a ferruginous spring, of 
which Rubio says,- that it has a considerable quantity of 
iron and a very small quantity of earthy constituents in 
it ; it is much resorted to by the Spaniards as a strong 


This is a fashionable bathing-place, and in a beau- 
tiful country ; a correspondent writes that " English 
might be fastidious about the accommodation, but the 
climate is so fine that one is always out of doors; 
indeed, rooms more furnished would be stuffy; at that 
season food is always abundant, and to my taste good." 
Spme years ago a Frenchman wrote: "If you take 
vapour-baths here, you will get ones at least as good as 
any to be had in Paris. Only they will cost you much 
less, and possibly do' you more good, thanks to the 
cleanliness which reigns in the comfortable establish- 
ment." The whole neighbourhood offers much of in- 
terest to the botanist and the geologist. 

France is not rich in desirable chalybeates. 

Bagneres de Bigorres^ in the valley of the Adour, is 
perhaps the most popular bath in France. There is 
beauty of situation, with good accommodation for visitors 
and a great supply of mineral waters. 

Their main character is derived from sulphate of 
lime. The baths of two of the weaker sources have 
already been mentioned. There is a cold sulphur spring 
at Labassere, containing sulphuret of sodium, the waters 
of which have been brought into Bigorres. There are 
three springs which contain carbonate of iron, and 
they differ from all other springs of the kind in their 
high temperature. The Theas well, with a temperature 
of 124*2°, contains 0*675 01 " i ron w * tn 22 g 15 - OI * mixed 
constituents, chiefly lime; the Reine, 115°, practically 



the same \ while the La Serre, 102 , has only one- 
third as much iron and some chloride of magnesia, 
which makes it somewhat purgative. Unfortunately 
these wells contain scarcely any gas to balance the 
heaviness of the sulphate of lime, hut this does not pre- 
vent their being found very useful in chlorosis and the 
cases for which iron is usually prescribed. Every arrange- 
ment has been made for providing amusement to the 
guests. The country is beautiful and the place easily 
reached, as it lies on the railway. 

Orezza, in the island of Corsica, is by far the best 

French chalybeate. It is comparatively pure, has a large 

quantity of carbonate of iron, and an abundant supply of 

carbonic acid. It is in a beautiful country, and amidst 

forests. It is in great repute locally in cases in which 

iron is indicated, especially in chlorosis and some of the 

complaints of women, and is said to be a specific in 

malarious poisoning, which is common in many parts of 

Corsica, but only when it has not gone the length of 

producing engorgement of the liver or spleen. Its waters 

are largely exported. The season is short — from the 

middle of June to the 30th of August. 

Forges les Eaux, department of the Lower Seine, has 
a very fair chalybeate, enjoying a reputation in chlorosis, 
the effects of haemorrhage, in dyspepsia, and in some 
diarrhoeas ; but, as a French guide-book says, it only 
suits those who like quiet and tranquillity. The only 
distraction is the promenade. The bathing establish- 


ment is surrounded by a well-wooded but rather damp 

Bussang, in a pretty situation in the Vosges country, 
close to the source of the Moselle, is a pleasant weak 
acidulous chalybeate. Its waters are largely exported, 
but not drunk on the spot; it is chiefly used as a 
table-drink. There is no drinking establishment, and 
a visit to Bussang merely makes a pleasant excursion 
for visitors at Plombieres Bains, or other baths in the 
Vosges country. 

Nor has England much to boast of in the way of 

Tunbridge Wells is almost the only source of the kind 
it possesses, and the quantity of iron is small, and there 
is little gas. Still it is a fairly pure chalybeate. At one 
time the waters were in great repute ; now they have fallen 
very much into neglect; but the place will always be 
popular owing to its bracing climate and the very pretty 
country in its vicinity. Those who go to Tunbridge 
Wells, and are likely to benefit by chalybeates, ought 
certainly to give the wells a trial. 

Harrogate. — The Tewitt well is a singularly pure weak 

To the list might be added two of the stronger wells, 
those of Arapatak, scarcely yet known, but containing in 
its two fountains, i*6o and 2*35 grains of the carbonate 
of iron, respectively. Also the newly-described iron 
spring at Wassenach near Tonnistein in the Brohl valley 


off the Rhine, which invites further observation. Better 
known is Dr. Muspratt's chalybeate at Harrogate* 
said to contain as much as 1*45 of carbonate, and i*8 
of chloride of iron, but along with 55 grs. of other salts. 
The value of this water, it is said, cannot be over- 
estimated. It is given in doses from 2 to 6 ozs. three 
times daily; but it is worth while to observe the 
qualification, " that the water must be given with much 
circumspection, as it frequently proves not only most 
difficult of digestion, but is apt to cause several of the 
most painful physiological effects common to pharma- 
ceutical preparations of iron ;" while the same writer 
finds the greatest improvement traceable to the action 
of steel for the use of the weak Tewitt chalybeate. 
This affords strong confirmation of what has already been 
said, that the system only takes up a certain amount of 

Waters with the sulphate of iron, if they are at all 
strong, are too disagreeable for the stomach to bear, and 
therefore of very little use, especially when alum also is 
present. To the milder wells of this kind belong Alexis- 
bad, and Mitterbad and Ratzes in the Tyrol, both greatly 
frequented by natives of the country and by Italians ; 
Auteuil and Passy, now included in Paris. The Passy 
waters are not much drunk, and the Auteuil ones are 
chiefly exported. They contain sulphates of iron and of 
lime, and some hydrosulphuric acid, and are counted a 
powerful tonic 


Under this head come the strong waters of Sandrock, 
Isle of Wight ; Vicars Bridge, near Dollar ; and HartfcU 
near Moffatt, besides many in Italy. At times the use 
of these waters has been recommended, but it has always 
been difficult to get patients to drink them, and they are 
very little used now. 



For convenience* sake I have thrown together into one 
chapter the few remarks which I have to make on some 
other varieties of waters. 

Many of the salt waters that have been above enume- 
rated, contain traces of iodine and bromine, some very 
considerable ones, and special effects of a very important 
kind have been attributed to them. It is hardly neces- 
sary to say that they are both very powerful medicines, 
both very active in promoting absorption (although much 
is not practically known of bromine m this respect), both, 
particularly the bromine, producing very marked effects 
on the central nervous system, and one certainly, when 
given in large doses, often producing the disagreeable 
symptoms of iodism, in many respects analogous to 
those of mercury ; suffice it to say, that those powerful 
effects are produced by large doses, that iodide of 
potassium is administered in doses of from 8 to 60 grs. 
daily, and that it is only since bromide of potass* 


has been used in still larger doses, that its remarkable 
properties, making it for the moment almost a panacea, 
have been discovered. 

Some of the salt waters that have been believed 
to produce all the effects of iodine, are those of 
Kreutznach, Durkheim, Wildegg, Krankenheil, Adelheids 
Quelle, Hall, Chalks in Savoy, and Castro Caro in Italy ; 
and if the analysis of it is to be trusted, Wood- 
hall Spa in England, our sole salt well for medicinal 
purposes, is as powerful as any of them, containing in 
the pint about 0*35 gr. of iodide of potass, and 0*64 
of bromide of sodium. Children at the last place are 
ordered t to 2 ozs. of the water; adults 4 ozs. three 
times daily. It is evident that in this case the children 
cannot receive more than a quarter of a grain of the 
two salts combined, and an adult not more than three- 
quarters. But in practical medicine we have no know- 
ledge of the operation of such small quantities. We 
therefore are thrown back on the chloride of sodium, 
which is the chief constituent of these waters, and we 
find that at Krankenheil, where there is not much salt 
in the spring, salt is added to the iodine water to increase 
its efficacy. 

Notwithstanding stories, to which it is impossible to 
attach credit, of iodism being induced by the use of such 
waters, it has been found at the Adelheids Quelle, that 54 
to 72 ozs. may be drunk daily for six weeks without any 
perceptible effect being produced, and a child between 


five and nine years may take a quart daily for any length 
of time. As to the Wildegg water, which is of about the 
same strength in iodides as Woodhall spa, for a long time 
they did not venture to go beyond tea-spoonful doses 
to children ; even now they say that young people should 
not take more than two or three glasses daily, but prac- 
tically it is at present considered valuable, merely as being 
a good vehicle for administering iodide of potass in ! 

As for the iodine waters of Saxon in Switzerland, 
which have of late years attracted attention, owing to 
the varying amount of iodine they contain, and the 
curious fact, which is apparently ascertained, that the 
rocks near the springs emit a distinct smell of iodine, 
one is sorry to think, that they have often been 
tampered with, and that artificially impregnated waters 
have been palmed off on the public for real ones. 

On the whole therefore, and as in every instance those 
small quantities of iodides or bromides are associated in 
mineral waters with large quantities of common salt, we 
are not warranted in assuming, that any effects are pro- 
duced by them, which may not be ascribed to the 
employment of the latter substance. 

This may be a convenient place for noticing shortly 
some of the other infinitesimal constituents of mineral 

Much importance was attributed some years ago to 
the discovery of arsenic in many of the mineral waters, 
and special effects were attributed to its presence. 



Arsenic is, however, now known to be a constituent of 
so many waters, of many excellent drinking waters, and 
it has always been found in such small quantities, that 
people have ceased to think much of it. It cannot 
seriously be considered as a therapeutic agent in 
mineral water cures. 

The discovery of lithium again in some waters 
exceptionally (of 0*5 of a gr. in the 16 ozs. in a well 
at Elster, and in the Murgquelle of as much as 2-36) 
seemed to promise something in the treatment of certain 
classes of disease. But although Bence Jones' experi- 
ments have shown the immense rapidity of the passage 
of lithium into the circulation, and of its reaching the 
joints, the hair, and even the lens of the eye, very 
little is really known of its use in medicine. The dose 
for an adult is set down as 3 to 6 grs. of carbonate of 
lithium thrice daily, certainly not less than 12 grs. a 
day, so that the minimum dose of the Murgquelle would 
be over five pints, which would contain more than 
half an ounce of other salts, and that of the next 
strongest well would be twenty-four pints daily. Much 
therefore can scarcely be expected from the Sources a 
Lithion at Baden Baden. 

Of the operation of minute quantities of copper, of 
strontium, of barium, or of rubidium, absolutely nothing 
is known. Borack acid is believed to be a solvent of 
calculi, but it has never been detected in wells, except in 
very minute quantities. 


As to the effects of manganese, which occurs in the 
fluids of the body, and in very trifling quantities in 
some mineral waters, this metal, when used medicinally, 
has been considered a tonic, and analogous in its 
effects to iron. But the only mineral waters containing 
any considerable amount of manganese, are those of 

Some writers attach importance to the presence of 
silicic acid in waters, and French writers in particular 
to the presence of silicates in some of the Pyrenean 
sources, but nothing in reality is known of its operation 
on the system. It is so difficult to tell, why the weakly 
mineralized waters of the Pyrenees exert on the system 
an influence beyond the ordinary thermal action of water, 
that extravagant importance has been attached to the 
presence of small quantities of sulphurets and of silicates 
in them. 

Carbonic acid forms so important an element in many 
mineral waters, their degree of palatability depending on 
its presence more than on anything else, that it requires a 
separate notice. 

Wonderfully little is known of its effects when taken 
into the stomach, beyond its immediate effect of pleasant 
stimulation, when taken in small quantities. Taken in 
large amounts, a portion of it is immediately got 
rid of by eructation, but enough may remain to cause 
a. certain amount of lightness of the head analogous 
to that caused by champagne, and sometimes a feeling 

u 2 


of distress about the heart, where the action of that 
organ or of the lungs is not free. This gas appears 
to act not only as a stimulant to the stomach, but also 
to the intestinal canal : in this way it is useful, parti- 
cularly associated as it usually is in mineral waters with 
small amounts of alkalies or of earthy salts, in indiges- 
tion and torpidity of the bowels. Sometimes these 
waters are of no small use in quieting irritability of the 
stomach. Carbonated water is at all times refreshing, 
and the use of such waters at the table is an adjuvant 
to other stronger waters, especially where alkalies are 

The waters in which carbonic acid is combined with 
salts in considerable quantities, have been already noticed 
under their several heads ; and as the weaker ones are 
chiefly used for the table and for exportation, it may 
be sufficient merely to enumerate some of them. As a 
general rule it may be said, that 6 to 10 inches of car- 
bonic acid in the 16 ozs. of water is quite sufficient to 
make it agreeable; quantities over 25 inches are in excess 
of what is wanted. 

These table waters may perhaps be divided, into those 
in which carbonate of soda and chloride of sodium 
predominate, and into those which contain lime or 
magnesia; there are often minute quantities of iron and 
of other salts also present 

The first are chiefly German ; they are very abundant 
in the Rhine country or near it, as Sdtzers % Hcppingm y 


Roisdorf, Tdnnistein,) Schwalheim 9 also at many other 
places, such as Kissingen, Briickenau, Giesshubel, Soultz- 
matt (which by the way is French). 

The second are chiefly French, as St. Alban, St. Gal- 
mier y Chateldon, Condi/lac, Renaison y Pougues. 

Carbonic, acid helps also to make some of the aperient 
waters already mentioned more palatable, such as those 
of Pulina and FriedrichsJiall. 

Artificial Waters. — When Bacon expressed surprise 
that "no man hath sought to make an imitation by 
art of natural baths and medicinable fountains," he was 
not aware that such imitations had been already 
made. Herodotus, indeed, a successor of Galen, had 
declared long ago, that the copies were not equal to the 

We have already seen that, as regards baths, every- 
thing has been done that Bacon could have wished; and 
it is the same with medicinable fountains, of which imita- 
tions have now for a long time past been prepared. 
They are truly called imitations, for they are seldom 
exact enough to rank even as accurate copies. 

And this is not surprising, while the exact chemical 
constitution of mineral waters is by no means positively 
determined. Whether the presence of minute quanti- 
ties of a great many salts is of any real importance, 
whether nature's polypharmacy is more valuable than 
man's or not, it is very difficult to add these fractional 
quantities accurately to artificial waters, and the organic 


matters, such as baregine, present in some, cannot be 
imitated at all. 

As these artificial waters are but imperfect copies, 
perhaps it would be better if the actual contents of 
the bottles were specified on the outside, instead of 
the name of the spring they imitate; indeed, the 
affixing names of places to artificial waters is forbidden 
in Austria. In most Continental countries a licence is 
required from the State for the manufacture of such 
waters. In any case, however, it is an objection against 
them, that we can only have the guarantee of the 
maker's name for their being what they profess to be. 
There is no certainty that they are of one uniform 

Strongly mineralized waters are the most easily imi- 
tated, and their imitations the most useful : weaker 
waters, in which there is great faith when they are drunk 
on the spot, as for instance those of Eaux Bonnes, can 
positively not be imitated with the slightest advantage. 
On the whole, therefore, now that the art of bottling 
waters securely is understood, and that it is known that 
most natural waters may be made to keep quite well, by 
the exclusion of all atmospheric air, it seems probable 
that the original bottled waters will be greater favourites 
with the public than their imitations. The only exception 
will probably be in favour of some of those used chiefly as 
articles of diet, such as soda and Seltzer waters, which 
owe their qualities mainly to the quantity of carbonic gas 


they contain, and which, without following very strictly 
any natural sources in their manufacture, are made very 
palatable — indeed often more so than the bottled waters 
in imitation of which they are made. 

We have at all events learnt something from nature's 
chemistry, and know that by the aid of carbonic gas we 
can present many medicines to the stomach in a palat- 
able shape, and one likely to favour their absorption. 
The exhibition of medicines in a state of effervescence is 
a great step in practical therapeutics. 

Alkaline and saline waters — such as those of Vichy, 
Bilin, Fachingen, or Carlsbad, Marienbad, and Eger— are 
among the best of these exported waters. Iron waters 
do not, even when the greatest care has been taken, 
keep well ; the iron constantly gets precipitated, and it 
may be much doubted whether Schwalbach or the weak 
Bussang waters, away from their sources, are so good as 
their imitations, or indeed so good as the ordinary 
milder pharmaceutical preparations of iron. 

Well-bottled waters from the original sources are how- 
ever, generally speaking, better than their imitations, and 
there can be little doubt that the mere medicinal action of 
the waters on the system, if they have not undergone de- 
composition, must be essentially the same, whether the 
patient drinks them fresh at the source or at home. But we 
have endeavoured to show, that the whole rationale of the 
use of mineral waters is different from that of taking ordi- 
nary mediqine ; that their value is immensely increased by 


the various aids, of entire change of air and of habits of 
life, of the baths and other appliances of watering-places. 
The influence of the imagination, too, is lost — one by no 
means to be overlooked. 

Although, therefore, there are various conditions in 
which the use of exported waters may be convenient, 
drinking them at home can never take the place of 
drinking them at their source, and this is the general 
feeling of patients ; they usually declare that mineral 
waters drunk at home, with the exception of some 
simple aperient ones, have not the same effect as 
when drunk at their fountain. 

The larger the amount of mineral constituents in a 
water, as a rule, the less does it suffer by transport 

The exportation of their waters is a considerable 
source of profit at many wells; the sale of exported 
waters has now become very extensive indeed, and is 
becoming greater every day. Waters even cross the 
Atlantic, and certain American ones are drunk with faith 
by many poor ladies, who hope to be cured of cancer, 
and of every conceivable malady, by their use. 

In concluding this division of my subject, I am happy to be able to 
give the last results obtained by my friend Dr. von Liebig with the 
compressed air apparatus, at Reichenhall. The amount of air 
expired under ordinary and under increased atmospheric pressure is 
found to be practically the same. The mean quantity of carbonic 
acid expired under high pressure is only a trifle less than under 
normal. If a man under ordinary pressure expires 755 grammes in 
the twenty -four hours, he would expire 727 under increased pressure. 


While the slowness of the pulse induced by compressed air does not 
last on removal from it, it is said that there is no doubt as to the 
retardation of the respirations continuing for some time. 

Some of the remarks in the Introduction might have been illus- 
trated by a reference to Boll Bad, a weak sulphur source, not far 
from Ulm. Here a bathing establishment, formerly the property of 
a company, is now used as a place for the cure of disease by prayer, 
under the superintendence of a pastor. There is a similar institu- 
tion on the Lake of Zurich. 

Perhaps I might have said more of some points of hydropathic 
practice, of Dr. Chapman's ice-bags, and of various artificial baths 
and inhalations, but I have been obliged to limit myself to such 
remedies as are used in connexion with bathing establishments, and 
for chronic disease. 

It is hardly necessary to say, that the terms hydrosulphuric acid 
and sulphuretted hydrogen, and chloride of sodium and common 
salt, have been used by me indifferently. 





In the enumeration of appliances connected with baths 
already given, one might suppose that the list of modes 
of treatment supplementary to regular medicine, had been 
exhausted. But this is far from being the case, as will 
appear most readily by looking at a few German bath 
advertisements, which contain many odd things, besides 
inquiries for a little English boy to come and play with 
another one for so many hours daily. 

At one place we hear of the wonderfully successful 
results, not only of pine-leave vapour-baths, but of steel, 
malt, bran, salt leys, salt spring, and vegetable baths. 
Another place, we are told, lies 1,700 feet high, " above 
the consumption zone." We read of Irish-Romish baths, 
with all kinds of medicinal, carbonic acid, and electric 
baths ; the English part of the advertisement describing 


them as "Turkish — tub — steam, and overthrowing baths." 
We also meet with this beautiful collection of remedies : 
goat whey and mineral water establishment ; also baths 
of Kreutznach salt ley, of sea-salt, of sulphur, of malt, 
of bog, of calmus (I suppose Calamus aromaticus), and 
of fir leaves ; also drinking cures of all sorts of herbs, 
as well as of natural and of artificial waters ; and we 
may wind up with a dietetic Schrothisch institution, 
where every disease under the sun is treated. 

Although the French very naturally praise the beauty 
and other attractions of their baths, I have not lighted 
on any of their advertisements which quite come up 
to the German ones. The following is a tolerably 
characteristic one : — " Perfected apparatuses, vast gymna- 
sium, baths of condensed air, a piscina for swimming, 
vapour baths and douches, medicinal and electrical baths, 
&a ; everything has been united to form a complete 
ensemble" I am quite aware that we have no want of 
more or less quackish advertisements in England, but 
their style is different from that of foreign ones, and 
certainly not superior. 

But of these numerous remedies, we can only glance 
at some having a bearing on diet, and diet mainly meant 
to cure in a season, like mineral waters. The popularity 
of some of these cures is unbounded ; and that patients 
have often benefited by them, is certain. It has been 
justly remarked, that it is not unworthy of the attention of 
the regular practitioner, to inquire what are the elements 




of success in such cases :* and these seem to be, first, 
that the patient, owing to the amount of faith which he 
places in a new mode of treatment, gives up injurious 
articles of diet, which he would not otherwise have done ; 
in the second place, a certain amount of simplicity of 
food and of regularity in the hours of taking it is enforced, 
which is advantageous in many cases ; and thirdly, these 
modes of treatment are believed in some instances to sup- 
ply to the system certain substances of which it is in want 

The dry method consists essentially in reducing the 
quantity of water drunk to a minimum, and making the 
diet consist chiefly of bread and biscuits ; while wine is 
allowed, and the smallest quantity of meat. A diet of 
this kind is continued for six or seven weeks. The 
essential of this mode of cure rests in the diminished 
supply of water, and the effect of this on the blood. 

This system has been for some years carried out at 
Marseilles, Montpellier, and other towns in the south of 
France, and in a variety of it, which has been called 
Schroth's cure, portions of the hydropathic treatment 
have been adopted. Every variety of disease is to be 
cured by- this method. It enforces abstinence, and the 

* Although it is quite ascertained that people can reduce their 
weight much by strict rules of diet, that which was called Banting's 
system is already out of fashion in England, while it is compara- 
tively in favour in Germany. Its main principle is, to select a diet 
consisting chiefly of albuminates, and especially of the lean of 
meat, with as few hydrates of carbon as possible, and one 'which is 
also somewhat stimulant, so as to favour the conversion of tissue. 


hunger cure has no doubt always been a valuable agent 
in medicine, although patients will rarely practise it in 
their own houses, especially in these days when the 
feeding up system is the fashionable one. 

Extract of Malt — Hoff 's extract is a sort of beer, 
which is moderately purgative, from the bark of the black 
cherry said to be used in its preparation. Its popularity 
has led to the preparation of purer extracts, such as 
Lincke's, and malt is an element of Liebig's- food for 
infants. Malt is at present wonderfully popular abroad, 
and even soaps of it are advertised. In former days 
in England the use of malt was recommended in scro- 
fula and phthisis ; and some of the highest modern 
German authorities, such as Niemeyer, bear testimony 
to the value of Lincke's preparation. He says that it 
is free from the deleterious properties occasionally 
manifested by Hoff 's beer. He has, in cases where a 
nourishing diet is required, and when the digestion is 
too weak for animal fats or cod-liver oil, administered it 
with the most satisfactory results. But extract of malt 
has been mentioned here chiefly owing to its richness in 
sugar, in which respect it excels ripe fruits and grapes, 
which we have to examine presently. 

In England herbalist cures are almost forgotten ; not so 
in Germany, where the cures of the shoemaker Lampe, 
at Goslar, were a few years ago counted marvellous ; but 
they would scarcely have come under our notice, were 
not such medicines used frequently in association with 


salt baths or some of the whey cures, and that in 
Germany they are often used as a preparation for 
bath cores. 

The fresh expressed juice of water-cress, dandelions, 
couch-grass, willows, &c, is recommended to be used 
in spring, but in moderate doses of two or three tea- 
spoonfuls daily on an empty stomach. Larger doses 
are not usually borne well. Where it does not agree 
with the stomach, we are directed after each spoonful to 
drink a wine-glassful of Seltzer water, and this to be fol- 
lowed by a cup of pure black coffee. Improved diges- 
tion, increased appetite, and slight movement of the 
bowels are the results of this treatment, which is usually 
continued eight to fourteen days. I should not myself 
recommend any such preparatory course. 

But another kind of bitters is prepared in two or three 
Alpine stations, which has at present a great reputation 
in Germany, and is doubtless of some use at both 
Reichenhall and Kreuth, where the drinking sources are 
of no great importance ; or at Heiden, where they have 
only whey. 

Apparently, bitters are favourites in all mountain 
climates. Just as bitters are at the present day made 
of the elegant common centaury (Erythraea centaurium), 
in the West Highlands of Scotland, and as old Burton 
recommended, " centry sodden in whey," so in Switzer- 
land they manufacture various compounds, rejoicing in 
such names as " Alpen kraiiter, magen bitter," all varying 


according to the fancy of the local compounder, all 
intended to stimulate the appetite. The Reichenhall 
bitters are prepared of the fresh juice of Taraxacum, 
Veronica beccabunga, Trifolium fibrinum, and Sisym- 
brium nasturtium, and are now largely despatched to all 
parts of Germany. I have no doubt that the prepara- 
tion may be efficacious, for it resembles many of our 
remedies for liver, and that it may be useful in cases 
where taraxacum is indicated — a medicine, by the way, 
to which a sort of specific action on the biliary secretions 
has been attributed. There is a considerable quantity 
of potass in the ash of the taraxacum bitter, to which 
a portion of its alterative qualities is ascribed, and no 
doubt potass acts more powerfully on the system than 
soda. Many patients become quite fond of this mixture ; 
I cannot pretend to have found it palatable. The dose 
is from one to two ounces daily, about ten o'clock in the 

Two other vegetable juices may just be mentioned. 
The sap of the birch tree, from which a pleasant effer- 
vescing drink is made in Scotland, and which in former 
days, taken in the quantity of eight ounces in the morn- 
ing, was thought to be anti-scorbutic, diuretic, and useful 
in stone. 

The sap of the ptne y which has of late years been used 
in the Landes, in quantities of half to a whole tumbler, 
morning and evening. It has been found useful in 
chronic bronchial affections, where digestion and assimi- 


lation are imperfect, and even in early stages of tuber- 

We might thus in many parts of Great Britain, particu- 
larly in Scotland, supply several of the popular continental 
remedies — bitters, sap of birch and of pine, pine balsam, 
in addition to peat and peat-water baths. But we pass 
on from these, most of them, curiosities of medicine. 

Fruit, and grapes in particular, have in all times been 

used both by physicians and by the laity as grateful and 

useful to patients in sickness, but it is only of late years 

that their systematic employment as a means of cure has 

become common. The juice of grapes consists of, in 

1,000 parts, 

Water 830—860 

Grape sugar . . . 150 — 300 
Other constituents . 20 — 30 

These last consist of silicates and phosphates, and 0: 
soda, potass, lime, &c. ; of tartrates of lime and of potass, 
of some mucose and pectin e. The skins contain aromad 
ethereal oils, and the stones a good deal of tannic aci 
and some fat. But the composition of the juice van 
immensely according to the weather of the particu 
year, the nature of the soil, the species of vine, its m 
of cultivation, the degree of ripeness, &c. On dry 
grapes yield much more sugar than on moist, more 
warm than in cold climates ; and the geological nature 
the soil has much effect on the nature of their inon 


In Switzerland the division of grapes into Fendants 
and non-Fendants is of some importance for the grape 
cure, as the first contain less sugar and less acid than 
the second, but more gum and albumen. The following 
analysis of 1,000 parts of the Claire tte (non-fendant) 
will give an idea of its chief constituents : — 

Water 824 


Gum and dextrine .... 
Albumen and nitrogenous matters 




Lime . 


Tartaric acid 

Malic do 





Grape juice has been compared with the waters of 
the Grande Grille at Vichy; in 10,000 parts the inorganic 
constituents are : — 

l' ; 

Grape Juice. 

Chlorine 0*26 . 

Sulphuric acid .... 1*09 . 
Phosphoric acid . . . 471 . 

Silicic acid 3*44 . 

Potass 17*94 

Soda 5*82 

Magnesia 276 

Lime 5*09 

Iron and Magnesia . . I '50 



Grande Grille. 




22*3 ) 



On the whole, therefore, the grape cure supplies us 
with a somewhat complicated solution of salts, along 
with a great deal of sugar and small quantities of albu- 
men and gum ; the salts combined with inorganic acids 
may amount in the x6 ozs. to 24 grs., with organic acids 
to nearly 40 grs., while the sugar may vary from 2 J to 
5 ozs. 

The following are the physiological effects of eating 
fresh" grapes. Little is known of the digestion of 
grape juice, but it is probable that the grape sugar is 
partly absorbed in the stomach unchanged, and is partly 
converted into lactic acid. Grapes usually, during the first 
few days, cause frequent and fluid motions ; after a few 
days, if the cure is borne, the purgative action becomes 
more regular, and varies from five to six motions a day; 
sometimes, however, there is no laxative action. Usually 
the appetite is increased, the digestion improved, fte 
secretion of bile increased, the circulation of the 
portal system and the peristaltic action of the bowels 
accelerated. Sometimes in the first few days there is a 
certain amount of excitement, with quickened and fuller 
pulse, and tendency to congestion of the head occurs; 
but this usually passes off, although this stimulation seems 
occasionally to have gone the length even of producing 
haemoptysis and ^bleeding at the nose. The grapes act 
with the greatest certainty on the kidneys, always aug- 
menting their secretion, and, like all fruits, rendering the 
urine alkaline, diminishing perhaps the amount of urei 


The general effect on the system is sometimes that of 
resolution and absorption, at other times it is nourishing 
and strengthening, and even produces fattening. But 
these effects vary much in different places and in differ- 
ent seasons, showing how much depends on the varying 
quality of the grapes. In the alleged fattening, the 
animal diet allowed and mountain air have their share. 

From what has been said of the physiological action 
of grapes, some of their uses may be inferred : — 

1 st General resolving action on the abdominal organs, 
exercised in everything depending on abdominal plethora. 
Good effects have been observed in dyspepsia, jaundice, 
congestion of liver, of spleen, and haemorrhoids ; in short, 
in most cases to which purgation is applicable. 

2d. In chronic catarrhs, whether of the respiratory 

or of the digestive mucous tracts. Combined with 

mountain air grapes seem undoubtedly to be of some 

use in the former ; in the latter they should be used with 

much care. They have frequently brought on irritation 

bordering on that of dysentery. Curchod's statement 

that he has cured with grapes many cases of diarrhoea 

among Indian officers is important, if such favourable 

results could be usually counted on. I am aware that 

lime juice is a favourite Italian remedy for diarrhoea; 

still I believe that unripe grapes would be injurious, 

and that the trial must be made with perfectly ripe ones. 

When they are efficacious, I take it to be much in the 

same way as the Indian Bel fruit is useful, which contains 

x 2 


little acid, but much mucose and pectine, the quantity 
of tannin present being so small, that much cannot be 
attributed to it 

3d. In the early stages of tuberculosis it is considered 
by many competent medical men to be of advantage, 
but this can probably only be the case when there is 
a tendency to inflammatory action. Probably they act 
by soothing the mucous surfaces; and the large 
quantity of. sugar, which has always been a favourite 
remedy in phthisis, present in grapes, may also help. 

These are some of the chief applications of the 
grape cure. I confess that, apart from the season 
of the year, and from other favourable influences 
co-operating, the effects do not appear to me to be 
very striking. Very discordant results have been ob- 
tained by those who prescribe the cure in different 
districts. Grapes often act as a rather irritating, unplea- 
sant purgative. 

The doctor must determine the quantity of grapes to 
be eaten in the particular case. It depends on the age 
and constitution of the patient and the nature of his 
malady. On the whole it may be counted at three to six 
pounds a day, and may reach eight and even twelve 
pounds. A man has been known to eat 300 pounds of 
grapes in four weeks. The grapes should be quite ripe, 
have thin skins, and the fewer stones the better. 

One begins with small quantities and goes on gradually 
to large ones, and the quantum is divided thus : about 


a quarter before breakfast, a half between breakfast and 
dinner, and the other fourth in the course of the evening. 
The meals are directed to be as simple as possible ; 
but there is no particular article among the simpler 
ones of diet to be avoided unless milk, which does 
not agree with the grape cure. Of course the skins 
are not swallowed, and it is an objection to the cure 
for children, that they are apt to swallow them. To 
save trouble in mastication, the fresh squeezed-out juice 
has been recommended. Small presses have been 
made to squeeze the grapes, and the juice will keep 
when well bottled ; but drinking it is not so efficacious 
as eating the grapes, in which process their juice is 
swallowed slowly, and properly mixed with the saliva. 
The average length of the course is three to four 

The grape cure occasionally produces very obstinate 
dyspeptic symptoms, with aphthae in the mouth, and 
jaundice, the latter chiefly in children, also a very 
disagreeable inflammation of the mouth. It is some- 
times injurious to the teeth, especially if caries exists. 
On the whole a grape cure is a powerful agent, and not 
to be too lightly undergone by patients. It suits men 
better than women, and is not at all adapted for children. 
The season for it is from the middle of September 
to October. 

Bingen and Durkheim, Vevay, Montreux, and Meran, 
are some of the favourite grape-cure stations. 


There are other fruit cures, such as cherries, apricots, 
pears, apples, lemons, oranges (ten to fifty in the day of 
these last), &c, but strawberries alone can be mentioned 

A rough analysis of wild strawberries gives in a 
thousand parts : water, 872 ; soluble substances, 64 ; in- 
soluble, 63. In the first, sugar, 32; free acids, 16; 
albuminous substances, 6; pectine, 1*5 ; ashes, 7*3. In 
the second, seeds, skin, and cellulose, 60 ; pectine, 3. 
Wild strawberries, of which we speak, contain much less 
sugar, but more salts than garden ones, and a little more 
acid. Strawberries contain twice as much acid as grapes, 
but only one-fifth of the same quantity of sugar, while 
they have about one-half more of salts. Their action 
appears to be aperient and diuretic. 

Strawberries used to be employed formerly by phy- 
sicians of repute in hypochondriasis, gout, and stone, 
and even in consumption, but little is known on the 
subject. Of late their use has been revived, and Inter- 
lachen is counted a convenient spot for their use, as they 
are abundant there the whole summer through : but we 
must recollect that, however refreshing strawberries are, 
they supply very little nutritious matter ; they contain less 
sugar than any other fruit, but a great deal of acid, and 
more iron. They are of course contra-indicated when 
there is a tendency to diarrhoea. Wild strawberries do 
not grow in such abundance in Great Britain as in many 
continental places. 



Milk supplies a complete specimen of an article of 
nutrition supplied by nature. It contains along with 
water, an albuminate in its casein, a fat in its butter, 
a compound of carbon in its milk-sugar, and besides 
this a small quantity of inorganic salts, and all these 
mixed in such a way as exactly to meet the wants of 
the suckling. But perfectly adapted though it is for 
them, it was never meant to be the sole food of children, 
much less of adults, as it does not possess the stimu- 
lating properties of other articles of diet, especially of 
meat. But though not sufficient by itself, it is most 
useful in conjunction with other food in modifying the 
nutrition of the system at all ages. 

Milk varies very considerably in its composition in 
different districts and countries. The way in which the 
cattle are fed has most effect on the quantity of the 
water, casein, butter, and sugar which it contains. 
Heavy rains produce a very marked effect. Various 
aromatic plants may in certain pasturages impart an 


aromatic flavour, just as turnips do theirs. Even dur- 
ing the course of the day there are considerable changes 
in milk. Although there is little difference in their 
specific gravity, yet the solid constituents of the evening 
milk are considerably greater than those of the morning, 
and very remarkably so in the amount of butter. 

Of the three kinds of milk chiefly used for invalids, 
cows' milk has the largest, asses' milk the smallest, amount 
of solid constituents. Goats' milk is between the two. 
Protein substances are also considerably more abundant 
in cows' than in goats' milk, while asses' milk does not 
contain one half so much of them as goats'. In amount 
of butter and of sugar, cows' and goats' milk are pretty 
much on a par. Asses' milk is very poor in butter, but 
richer in sugar and in salts, than either cows' or goats' 
milk. The accounts of ewes' milk vary, but on the 
whole it is rich in constituents. Mares' milk seems to 
be poor in butter and casein, but to be rich in sugar. 
Buffaloes' milk, according to Vernois' analysis, is very 

In round numbers cows' milk may be said to consist* 
of, water, 857 parts ; casein, 48 ; albumine, 6 ; butter, 43 ; 
milk-sugar, 40; salts, 6. These salts consist chiefly of 

* Good milk should contain 130 to 140 parts of solids in the 
1,000 parts. A comparative table of milk from Becquerel and 
Vernois gives as much as 196 for Angus, 182 for Tyrol, 162 for 
Bretagne, 160 for Holland, 142 for Belgium. Muspratt gives 135 
as the average for England ; but London milk falls short of that 


phosphates of lime and magnesia, iron, chloride of potass 
and of soda, and phosphates of the same. 

Skimmed milk is the milk with the cream removed, 
after it has risen to the surface ; butter-milk is what 
remains of the cream after it has been deprived of its 
butter; whey is the serum of the milk which remains 
after the butter and curds have been removed, but a 
considerable portion of its salts are lost, most of its 
phosphates being precipitated in combination with the 
casein. Ten parts of milk yield about six of whey. In 
a general way a pound of whey may be said to contain 
from 36 to 40 grs. of salts, consisting of 10 to 14 grs. of 
chloride of potass, 2 to 3 grs. of chloride of sodium, and 
some 20 grs. of phosphates, besides about 350 grs. of 

With respect to the physiological action of milk and of 
whey when drunk, — in the case of milk, the casein is 
iirst coagulated by the gastric fluids, and is afterwards 
partly dissolved in the process of digestion, by the ap- 
proach of alkaline fluids and of bile, and, perhaps, partly 
converted into an albuminous solution. The whole of 
the casein appears never to be absorbed by the stomach ; 
a, small portion passes into the duodenum. The butter, 
which oxidizes slowly, appears to be re-absorbed in the 
small intestines unaltered, and reaches the lacteals in the 
form of an emulsion ; while the greater portion of the milk 
sugar is converted into lactic acid, and reaches the blood, 
wriere it is readily oxidized. 


■■■■^ ■■»■■■■——■ ■ ■-■■■. I, 1 1 I. ■ i ■ ■ —■ — -..■ — ■ i — — ^ —......- ■ — . . 

As to the general effect on the system, there is no 
food that is so quickly digested by a healthy stomach, 
none that excites so little. Indeed some have attributed 
a soporific action to it; it does not increase the pro- 
duction of heat or quicken the circulation ; and if it 
increases any secretion, it is that of the urine. As so 
much of the milk is absorbed into the system, only small 
masses of faeces are formed. Its tendency, therefore, 
besides being generally sheathing to the intesltines, is to 
cause constipation. Milk is unusually nourishing, and 
promotes the deposition of fat, especially when it contains 
much cream. 

The action of the whey, which is a weak solution of 
salts and of milk-sugar, and is a fluid with a mawkish 
taste, which is agreeable to very few persons, is not very 
marked ; in large quantities it readily produces dyspepsia 
and an uncomfortable state of the mouth and gums. 
It is generally laxative, often producing diarrhoea. It 
acts very distinctly as a diuretic, but it also occasionally 
causes constipation, and even a slight amount of jaundice. 
It is believed to increase the secretion of mucous surfaces, 
of the liver and of the skin. If not taken in too great 
quantity, whey is absorbed rapidly. The clearer it is, 
that is, the less butter or casein it contains, the less 
likely is it to cause dyspepsia. 

Milk has long been used in sickness and in cases of 
debility. Hippocrates used to order milk and wine. At 
the present day milk and brandy are often used in recon- 


stituent medicine ; and what more popular remedy is 
there than old man's milk ? Who has not had occasion 
to witness the good effects of milk and lime water in 
irritation of the stomach, and in some forms of dyspepsia? 
But it is rather with the systematic use of milk as an 
article of diet that we have here to do, and more parti- 
cularly with its nutritive effect in combination with 
country and mountain air ; as, however, I think it is not 
sufficiently valued in medicine, I shall say a few words as 
to its use in some forms of chronic disease. 

In various advanced stages of disease, and of perverted 

nutrition, of which it is difficult to define the exact nature, 

but in which drugs appear to have no effect, the steady 

use of milk appears to produce a complete change of the 

nutrition. Dr. Karell of St. Petersburg, and others, 

have advocated its use in somewhat of the following 

manner : the patient begins with 2 to 6 ozs. of milk three 

times daily ; it must be taken at fixed hours, for if specific 

directions are not given, as for medicine, the patient will 

not adhere to the use of it. The quantity, when the 

milk agrees, is to be gradually increased, and patients 

often get to take as much as to or 12 glasses daily; the 

good effects are then apt to cease, and it is necessary to 

revert to the small doses again. The milk is generally 

best borne tepid, and should be taken in slowly, just as 

grapes should not be eaten when very cold, and should 

be swallowed gradually. If the milk causes much thirst, 

a little seltzer water may be taken. Patients are to 


be kept as much as possible to this diet, but a little stale 
bread one day and milk soup the next may be allowed. 

Dr. Karell says that from this treatment he has met 
with quite unexpected success in various cases of hypo- 
chondriasis and dyspepsia, neuralgic affections of the in- 
testines, in congested liver, and even in dropsy connected 
with enlarged liver. Dr. G. Keith of Edinburgh tells 
me he has used the treatment with extraordinary success 
in some of these last cases, and also (what from my own 
experience I should quite be inclined to expect) in old 
diarrhoeas ; but he finds it difficult to get patients to stick 
rigorously to the milk, and to small quantities of it The 
complete rationale of the good effects of milk given in 
this way is not very plain. 

But the good effects of milk diet in general conditions 
of the system, and where there is a tendency to tuber- 
culosis, are much more generally admitted. It is accord- 
ingly often found extremely useful in combination with 
country air in anaemic states, the result of acute illness, 
or of loss of blood in scrofulous and rachitic children, 
but, above all, in threatened tuberculosis, in which its 
use has been popular, with some interruptions, since 
Galen used to send patients suffering from it to the 
milk cure at Stabiae. 

The general indications for its use are so well laid 
down by Niemeyer, that I shall quote what he says : 
"In the selection of suitable diet for consumptive 
patients the old rules, derived partly from common expe- 


rience, agree completely with the views now received in 
physiology respecting nourishment and renewal of tissue. 
All the articles of food especially recommended to 
consumptive patients contain large quantities of fat, or 
of substances which form it, and proportionately little 
of protein substances. This selection corresponds with 
the empirically ascertained fact, that the production of 
urea or the conversion of nitrogenous elements is in- 
creased by a large supply of protein substances, while 
on the other hand the conversion and expenditure of 
the organs and tissues most important to the organism 
is reduced by an abundant supply of fat and fat-forming 
articles. Therefore the freest possible use of milk cannot 
be too strongly recommended to phthisical patients. 
But it is entirely superfluous, and indeed erroneous, to 
remove the casein from the milk, and make it be 
drunk in the shape of whey 3 this can only be neces- 
sary in the rare cases, when the stomach bears whey 
well and milk badly. When I frequently order my 
patients to drink three times daily a pint of milk warm 
from the cow, my only object is that the milk should 
not be robbed of any of its constituents or skimmed 
before it is drunk." 

Warm milk is, like other warm fluids, useful in chronic 
bronchitis. Milk is also an agent of very great value 
in. affections of the stomach and of the intestines. It 
is easy to see how it is useful when we do not wish 
to give these organs much work to do; in chronic 


catarrhs of the stomach, and in perforating ulcer, milk 
is constantly used with great advantage. In infants, 
when amylaceous food is given too early, a return to 
milk is often the appropriate remedy. It is also use- 
ful in chronic diarrhoea and dysentery ; in the chronic 
diarrhoea of children its use is familiar ; and it is an 
old and rather neglected remedy in dysentery. If used 
with care, it is a valuable adjunct in many stages of 
the disease, and I believe that if more freely and sys- 
tematically used, it would be found to be one of the 
best cures for the obstinate diarrhoeas and other sequelae 
of tropical dysentery ; of course the milk must be taken 
with care, and it must be ascertained whether it is di- 
gested or not. If given in too large quantities, it may 
overload the stomach and increase the diarrhoea. 

To improve general constitutional states there is no 
necessity, as in Dr. KarelTs employment of it, for the 
milk being drunk at precise hours and in precise quan- 
tities. The chief object is to drink the milk in such 
quantities as are digestible. There is no virtue in drink- 
ing milk warm from the cow if you do not like it ; many 
drink cold milk more readily. It is better to have it 
previously boiled. The following is the regimen usually 
recommended. Let the breakfast be of milk, and let 
three or four cups be taken of warmed milk with some 
bread or biscuit. It is best to begin with skimmed milk, 
as the milk is often rich in Alpine pasturages. There is 
no objection to a little cocoa or tea with it. Some hours 




later, or about ten or eleven o'clock, the patient should 
take two more cups of milk. At one or two o'clock the 
patient should have a simple but nourishing diet of roast 
meat and vegetables, with a glass of good wine or of 
sound beer. At five or six in the afternoon two more 
cups and some bread should be taken, and thus 
patients may gradually come up to sixteen or twenty 
cups daily. At any time when the patient begins to get 
tired of the quantity of milk, or there are symptoms of 
its disagreeing, the quantity is to be reduced, or even for 
a time discontinued ; there are few patients who, if they 
begin with small doses, cannot take milk, although a 
patient will often assure you that milk always disagrees 
with him. 

The main virtue of a milk diet is, that it supplies 
nutriment which can be easily assimilated, and does not 
make any great call on the powers of the system. 

Whey. — Although it is only within the last few years 
that the use of this drink has reached its full develop- 
ment, it is by no means a new remedy. Old Burton, while 
he thought milk increased melancholy, said that whey 
was most wholesome. About a hundred years ago we 
read of people going to the head of the Solway Firth 
for three weeks " to the whey," or to the Highlands for 
goats' whey, and Tabitha Bramble was very near send- 
ing her dog Jowler to the whey cure at Abergavenny ; 
and Bath posset, or whey, used to be made by boiling 
two parts of the mineral water with one of milk. 


There is a great deal of fancy about the selection of 
particular kinds of whey. Cows', goats', and ewe milk whey 
all have their advocates ; but goats 1 milk whey has a strong 
smell which is distasteful to many ; the cows' milk has 
no unpleasant odour or flavour, while ewe-milk has 
no disagreeable smell, and its taste is very pleasant ; 
it is decidedly the nicest to take of the wheys. We 
are often told of the aromatic flavour imparted by the 
herbs that the animals have grazed on, but such flavour 
is always lost in the preparation of whey. Then it is 
asserted that the rennet, or prepared piece of stomach 
employed in making the whey, must be got from that 
of an animal of the same species ; for instance, that you 
cannot get good goats' whey if you use the rennet of 
calf. Then in various places different herbs are em- 
ployed in imparting flavour to the whey. There is a 
general feeling in favour of Swiss whey; and if they 
are not in Switzerland, patients are gratified to learn 
that the whey is made by a native of Appenzell, and 
still better pleased, if the said native shows himself in 
his national costume. 

The general composition of whey has been given 
above, but particular kinds are thought to be most 
useful in different complaints; thus, goat milk whey is 
considered best in chest affections, cows' milk for ab- 
dominal ailments, and ewe-milk as most generally 
nourishing: but these rules are often as arbitrary as 
the distinction between the mineral waters of the 


same place, when they scarcely vary at all in com- 

Whey (the main therapeutic value of which is probably 
as a nutritive drink) is recommended theoretically, as 
supplying to the blood only non-nitrogenous elements, 
the nitrogenous casein and the fat being excluded ; the 
notion is, that the constitution of the fluids and tissues 
of the body is altered and improved by the salts and 
milk-sugar whieh it contains, while the nitrogenous 
elements are withheld. But these theoretical ideas 
are of no real importance, as long as all patients 
drinking whey at the same time use a diet in which there 
is an abundance of nitrogenous or protein substances ; 
some have attributed special virtues to the small quan- 
tity of the salts of potass present in whey. 

The whey cure is recommended in chronic bronchial 
and laryngeal catarrhs, in tuberculosis and haemoptysis, 
in chronic catarrh of the stomachy in congestion of the 
liver, and in haemorrhoids. 

In the first of these affections we have already seen, 
that warm water is a useful remedy, and it is probably 
to the whey being drunk warm, that its good effects are 
to be attributed. 

In pulmooary phthisis it is for its more erethic, excit* 
i£>le form, in which inflammation occurs from time to 
iine, and active haemorrhage, that the whey cure is re- 
ommended. In most cases the operation of whey may 
)p considered mildly anticatarrhal and antiphlogistic. 

' Y 

. 1 


But for the more torpid forms of consumption it is not 
adapted ; and where there is much acidity present, as 
in some forms of incipient phthisis, and still more when 
there is diarrhoea, the whey is contra-indicated. 

In abdominal affections, whey acts chiefly as giving 
hardly any work to the digestive organs to do, and as 
a mild aperient; but it is apt to cause dyspepsia and 
diarrhoea. While it has many advocates for its use in 
haemorrhoids and abdominal obstructions, the general 
voice is against its employment in catarrhs of the 
stomach or in perforating ulcer. 

Whey, on the whole, is by no means the mild remedy 
that it is usually supposed to be; its continued use is 
often very lowering ; at the same time there is no ques- 
tion, that many people thrive on it and on mountain air. 

If milk, a natural product, easily causes indigestion, 
and is not suited to be singly the food of adult man, 
much less is the artificial product whey fitted to 
be so. Adults going through a milk cure, use ordi- 
nary articles of diet; in a whey cure they must do it, 
or would suffer excessively in their nutrition. Useful, 
therefore, though milk may be under many circumstances, 
and whey occasionally, most of the success claimed for 
systematic milk and whey cures may be very fairly set 
down to change of mode of living, to great simplicity 
of diet, to exercise in the open air at the best season 
of the year, and to the pure air of Alpine elevations. 

Milk and whey cures are to be obtained almost even- 


where : but for the English, Ems, Schlangehbad and Ba- 
denweiler may be recommended in the low country ; Ischl, 
Reichenhall, and Kreuth in the Eastern Alps ; Gats, Weiss- 
bad, Heiden, or Interlachen, in Switzerland. 

The supply of whey at most baths is abundant, and 
there are few places where a great many of the patients, 
particularly ladies, are not directed to drink the waters 
mixed with whey. Whey by itself is mawkish, and these 
mixtures appear to me to be singularly disagreeable to 
take, and therefore not particularly suitable for delicate 

I do not see why we should not have ewe-milk whey 
cures in Great Britain, especially in some parts of Scot- 
land, although I believe regular systematic whey cures 
are less popular in Germany and in Switzerland at 
present, than they used to be. 

The mode of life at Gais, the oldest of the Swiss whey 
cures, is thus described : — " At six o'clock in the morn- 
ing the bell rings to let people know that the whey has 
arrived. A tub of whey is set down before each hotel, 
from which the kellner fills up the glasses of the guests, 
which contain one to three choppins. Whoever comes 
too late, has to wait for the next supply, as the whey 
must be drunk warm; however, he can never have to 
wait long, as the bell sounds every quarter of an hour up 
to half-past seven or eight o'clock, announcing the arrival 
of fresh relays. In the intervals of drinking, the patient 
-walks about. When a patient has drunk the quantity 

Y 2 


directed, he takes a longer walk. In bad weather the 
whey is drunk in the tarsal The bell calls to breakfast 
at nine o'clock, which consists of soup, coffee, or tea and 
bread. From half-past six to halfpast twelve the guests 
amuse themselves with walking, with conversation, music, 
or billiards. About half-past twelve dinner commences, 
when patients must eat according to the directions they 
receive, but the table is ample and varied. After dinner 
come longer walks, and at eight o'clock the bell rings 
for supper." 

Patients begin with one glass, and go up to three or 
four glasses. If the whey is taken in larger quantities, 
the stomach is oppressed, and sometimes headache and 
giddiness are occasioned. On this account, patients 
with delicate stomachs should commence with very small 
quantities, less than half a glass. The drinking suc- 
cessive glasses rapidly after each other is to be avoided. 
If diarrhoea is the result, the quantity drunk is to be 
reduced ; if constipation occurs, any of the bitter waters 
may be used, in small quantity, at bed-tirae. Loss of 
appetite, weariness, and other effects somewhat resembling 
the saturation by mineral waters sometimes occur, and 
for this the doctor must be consulted. 

Cows' milk, goats' milk, and ewe milk whey are given 
in different places ; many do not like goats' milk whey ; 
on the whole, the cow milk is best borne. Ewe milk 
whey contains about two per cent of albuminates, cows' 
and goats' about one per cent 


I ■■ ■ " ■'■ > ■ ■ ■■■!■■■ I— ill ■ ■ ■■! - - . ■ I . — ■ ■ ■ ■ ■ ■ I I . |l 1 

The most favourable season for the whey cure is 
spring; but the season varies much according to the 
elevation of the station. 

The duration of a whey cure is very various. If the 
digestion does not suffer, it may be prolonged ; and if it 
really be effective in tuberculosis, it is evidently only from 
long-continued courses of it, that much beneficial altera- 
tion in the nutrition of the system can be expected. It 
is not uncommon to drink the whey in spring, then stop 
during summer, and have a second course in autumn. 

Butter-milk has been much used in diseases of the 
stomach, and in perforating ulcer, and is applicable 
where milk can be better supported by the stomach 
without its cream. For such cases it is suited ; but 
even practical men have at times become enthusiastic 
about its virtues, and recommended it in hysteric cata- 
lepsy and spinal irritation ! 

Cream may in a certain number of cases be found 
useful in producing improved nutrition in the same way 
as cod-liver oil ; but many stomachs cannot bear it I 
have known an attack of extreme violence, and re- 
sembling Asiatic cholera, follow the swallowing of too 
large a quantity of it 

Sour Milk. — It is well known that milk, if left exposed 
to the air, soon turns sour and coagulates. This is be- 
lieved to depend partly on the formation of minute fungi, 
of bacterias and of vibrios, and partly on the conversion 
of milk-sugar into lactic acid. The souring is readily 


• ■ ! ■ — ^———^—^— ^ ■ ■ ■ » i. ^ . ■■■■■ ■ . — .1.11^ . - _ _ i -. 

caused by changes of temperature and atmospherical 
influences ; nay, even the vessel in which the milk is 
kept, seems to have a. wonderful influence on the process. 

When milk has soured, its casein and lactic acid 
do not appear to interfere with digestion; indeed many 
writers, particularly some Vienna ones, have of late 
thought it more easily digested than fresh milk. Sweet 
milk, when it enters the stomach, has its casein coagu- 
lated and then redissolved, and it is the opinion of 
many, that the casein which has coagulated exposed 
to atmospheric influences, is more easily dissolved again 
than the other. 

It is chiefly in disorders of the digestive organs that 
the superiority of sour milk is maintained. There 
seems to be no doubt that casein is easily digested by 
most stomachs. One of its forms is known in Scotland 
as Corstorphine Cream. Sour or curdled milk, under the 
name of Dahi, is a popular article of diet, indeed of 
medicinal regimen, among the natives of India. They 
also preserve it dry and powdered, and in the East 
generally it is often prepared mixed with flour. 

Koumis. — Another result of the decomposition of 
milk, is a sort of spirit procured by the Tartars from 
the fermentation of mares' milk, no doubt mainly from 
the transmutation of the milk-sugar. 

It is much used by them as a strengthening article of 
diet, and of late years it has attracted some notice in 
Europe as a tonic remedy. It is considered a great 


restorative in depressed states of the system, and, com- 
bined with the fresh air of the steppes, is believed to 
be just as efficacious as whey supported by an Alpine 

I should not have thought it necessary to allude to 
the koumis here, had not some attempts been made 
to introduce it into Europe, Besides being used in 
various Russian towns, it has been employed at Bremer- 
haven, at Salzbrunn, at Gorbersdorf in Germany, and at 
Eaux Bonnes in the Pyrenees. 




Anaemia, 40, 151, 214. 
Asthma, 50. 

Bath fever, 82. 

Bronchitis, 43, 82, 1 1 8, 131, 
180, 201, 238^ 

Cachexia, tropical, 215. 
Chlorosis, 40, 270. 
Constipation, 254. 

Dartre, 129. 
Diabetes, 237, 253. 
Diarrhoea, 36, 65, 216, 307, 318. 
Dysentery, 36, 229, 318. 
Dyspepsia, 40, 190, 216, 235. 

Ear, 176, 216. 
Eye, 176, 216. 

Gall-stones, 237. 

Gout, 64,^80, 107, 120, 238. 

Hematuria, 61. 
Haemorrhoids, 201, 251, 322. 
Hyperesthesia, 64, 105, 151, 

160, 270. 
Hypochondriasis, 64, no, 251. 
Hysteria, 64, 105, no, 115, 152. 

Insanity, 65, 85, 1 10. 
Intermittent fever, 73, 197. 

Joints, 108, 170, 171. 
Kidneys, 43, 69. 

Laryngitis, chronic, 82, 131. 
Leucorrhoea, 160, 194, 238. 
Lithiasis, 238, 253. 
Liver, 81, 197, 201, 203, 216, 
229, 236, 252, 303, 316. 

Metallic poisoning, 80, 108, 131, 

Neuralgia, 165, 117,270. 

Obesity, 231, 242, 265. 

Paralysis, 64, 106, 113, 176. 
Pharyngitis, chronic, 236. 
Phthisis, 37, 38, 39, 43, 44, 119, 
187, 201, 280,307, 316, 321. 

Rachitis, 189. 

Rheumatism, 43, 64, 108, 117, 
120, 174, 226. 



Scrofula, 160, 161, 190, 220. 
Skin affections, 45, 65, 123, 128, 

162, 256. 
Spinal irritation, 105, 171, 195. 
Spleen, 122, 197,216, 252, 269. 
Stomach, 81, 117, 119, 318, 325. 
Sunstroke, 64, 1 10. 
Syphilis, 130. 

Tabes dorsalis, 107, 152. 
Tumours, 145, 157, 170. 

Urinary affections, 190, 238. 
Uterine affections, 64, 105, 115, 
117, 128, 160, 176, 217, 231. 

Wounds, 108, 131. 



Abano, 142. 

Acqui, 142. 

Adelheids Quelle, 288. 

Agueda, St 208, 281. 

Aixla-Chapelle, 140, 203, 2x1. 

Aix, Savoy, 137, 105. 

Ajaccio, 43. 

Alban, St. 293. 

Alexisbad, 272, 273, 275, 2S5. 

Algiers, 43. 

Allevard, 206. 

Alveneu, 206. 

Alzola, 195. 

Amand, St. 1 24. 

Amelie les Bains, 44, 135, 211. 

Aranjuez, 254. 

Arapatak, 284. 

Arcachon, 43, 183. 

Archena, 143. 

Aussee, 155. 

Auteuil, 285. 

Ax, 105, 136. 

Baden Baden, 148, 218, 223. 
Baden, Swiss, 99, 105, 139. 
Baden, Austria, 99, 140. 
Baden weiler, 104, 113, 323. 
Bagneres de Bigbrres, 104, 124, 

272, 273, 282. 
Bagneres de Luchon, 105, 134, 

Bains, 284. 

Balaruc, 149, 223. 

Bareges, 131, 105, 21 r. 

Bath, 98, 125, 191. 

Battaglia, 142. 

Berck-sur-Mer, 161. 

Bernardhine, St 272, 273, 280. 

Bertrich, 115. 

Bex, 156. 

Biarritz, 163. 

Bilin, 116, 240, 247. 

Bingen, 309. 

Birmersdorf, 253. 

Blankenberg, 163. 

Booklet, 272, 273, 276. 

Boll Bad, 297. 

Borraio, 104, 121, 191. 

Boulogne, 163. 

Bourbon l'Archambault, 149. 

Bourbonne les Bains, 148, 218, 

Bourboule, 240, 258, 263. 
Bournemouth, 183. 
Braemar, 46. 
Bray, 165. 

Bridge of Allan, 218, 232. 
Bridge of Earn, 233. 
Brighton, 164. 
Briickenau, 273, 276, 293. 
Bundoran, 165. 
Burtscheid, 140, 211. 
Bussang, 284. 
Buxton, 82, 104, 119. 



Caldas de Montbuy, 149. 
Cannes, 43. 

Canstatt, 150, 218, 224, 272. 
Caratraca, 207. 
Carballo, 143. 
Carlsbad, 258. 
Castellamare, 226. 
Castro Caro, 288. 
Catini, Monte, 228. 
Cauterets, 105, 132. 
Cestona, 229. 
Chateau D'Ex, 37. 
Chateldon, 293. 
Challes, 288. 
Chaudes Aigues, 243. 
Cheltenham, 254, 256. 
Chianciano, 104, 193. 
Clifton, 126. 
Clyde, 164. 
Condillac, 293. 
Contrexeville, 185, 194. 
Cortegada, 143. 
Courmayeur, 104, '193. 
Cronthal, 150, 2 1 8, 224. 
Cransac, 197. 
Cuntis, 143. 
Cushindall, 165. 

Davos, 37. 

Dax, 90. 

Deba, 163. 

Didier, St. 123. 

Dieppe, 163. 

Dore, Mont, 243. 

Driberg, 272, 273, 275. 

Dunkirk, 163. 

Diirkheim, 156, 218, 288, 309. 

Eaux Bonnes, 105, 186. 
Eaux Chaudes, 133, 211. 

Egypt, 43- , 
^ Eichwald, 116. 
Eilsen, 202, 21 1. 
Elster, 258, 262, 272. 
Ems, 240, 245, 323. 

Enghien, 207. 
Epsom, 253, 254. 
Escaldas, 105, 137. 
Euzet, 185. 

Fachingen, 240, 247, 272. 
Fecamp, 163. 
Fideris, 39, 240, 248. 
Fishguard, 164. 
Forges, 283. 
Fitero, 196. 

Franzensbad, 258, 262, 272. 
Friederichshall, 254. 
Fiired, 192. 

Gais, 37, 323. 
Galmier, St. 293. 
Gastein, 83, 104, 109. 
Geilnau, 240, 272. 
Gervais, St. 254, 255. 
Giesshtibel, 240, 272, 293. 
Gilsland, 208. 
Gleichenberg, 240, 248. 
Glenarm, 165. 
Gorbersdorf, 38. 
Groswardein, 221. 
Guagno, 138. 
Guitera, 138. 
Gurnigel, 204. 

Hall, 288. 

Harrogate, 211, 218, 230, 272, 

273, 284. 
Hartfell, 285. 
Heiden, 302, 323. 
Heilbrunnen, 240, 245, 272. 
Heligoland, 162. 
Heppingen, 292. 
Heustrich, 205. 
Himalaya, 36, 27. 
Homburg, 218, 222, 272. 
Hyeres, 43. 

India, 98. 
Innerleithen, 233. 
Innspriick, 41. 



Interlachen, 37, 310, 323. 
Ischia, 225, 240. 
Ischl, 154, 323. 

Kilkee, 165. 

Kissingen, 154, 218, 220, 272, 

293- . 
Krankenheil, 288. 

Kreuth, 155, 302, 323. 

Kreutznach, 156, 218, 223, 272, 


Langenbriicken, 202. 
Leamington, 254, 257. 
Leghorn, 164. 
Ledesma, 143. 
Lenk, 204. 

Leukerbad, 37, 104, 123, 191. 
Liebenstein, 273, 276. 
Liebenzell, 104, 113. 
Lippspringe, 191. 
Lisduvarna, 210. 
Llanstephan, 164. 
Lucca, 120, 191. 
Luhatschowitz, 240, 248. 

Madeira, 43. 

Madrid, 37. 

Malaga, 43. 

Mallow, 126. 

Margate, 161. 

Manenbad, 258, 261, 272, 273. 

Marlioz, 138. 

Matlock, 120. 

Meimberg, 203. 

Mentone, 43. 

Meran, 44, 309. 

Mitterbad, 285. 

Moffatt, 209. 

Montreux, 31, 44, 309. 

Moritz, St. 273, 278. 

Motrico, 163. 

Munich, 37. 

Nairn, 164. 

Naples, 164. 
Nauheim, 153, 218, 223. 
Nectaire, St. 244. 
Neilgherries, 27. 
Nenndorf, 202. 
N^ris, 117. 
Neuenahr, 240, 246. 
Newcastle, 165. 
Nice, 43, 164. 
Norderney, 162. 

Ofen, 99. 
Ontaneda, 143. 
Orezza, 273, 283. 
Ormetzaguy, 208. 
Ostend, 163. 
Oviedo, Caldas de, 117. 

.Paderborn, 191. 

Palermo, 43. 

Panticosa, 104, 118, 186. 

Passy, 285. 

Pau, 43. 

Petersthal, 272, 273, 278. 

Pfeffers, 104, no. 

Pietrapolo, 138. 

Pisa, 43, 120. 

Plombieres, 104, 116, 187. 

Porretta, la, 105, 227. 

Portobello, 164. 

Portrush, 165. 

Pougues, 185, 194, 293. 

Pozzuoli, 227. 

Prese, le, 205. 

Preste, la, 206. 

Piillna, 253, 254. 

Puzzicnello, 138. 

Pyrmont, 218, 224, 273, 274. 

Ragatz, no. 

Ratzes, 285. 

Recoaro, 272, 273, 281. 

Rehme, 153. 

Reichenhall, 155, 302, 323. 



Reinertz, 272. 
Renaison, 293. 
Rheinfeld, 156. 
Rigischeideck, 39. 
Rippoldsau, 272, 273, 278. 
Rohitsch, 258, 264. 
Roisdorf, 293. 
Romersbad, 104, 110. 
Rosstrevor, 165. 
Royat, 240, 244. 

Sacedon, 125. 
Saidschutz, 253. 
Sandrock, 285. 
Sauveur, St. 105, 133. 
Scarborough, 164, 257. 
Scheveningen, 162. 
Schinznach, 105, 139, 21 1. 
Schlangenbad, 104, 114, 323. 
Schonau, 115. 
Schwalbach, 272, 273, 277. 
Schwalheim, 293. 
Sebastian, San, 163. 
Seidlitz, 253. 
Seltzer, 292. 

Soden, 150, 218, 224, 272. 
Soultzmatt, 244, 293. 
Soutoraran, 163. 
Spa, 272, 273. 
Spezzia, 43. 
Stachelberg, 204. 
Strathpeffer, 209, 21 X. 
Swanlinbar, 21 ex 

Tarasp, 39, 258, 264, 273. 

Teinach, 113. 

Teplitz, 104, 115. 

Tonnistein, 293. 

Trillo, 15a 

Trouville, i6j« 

Tunbridge Wells, 273, 284. 

Uriage, 254, 256. 

Vacia, Madrid, 254. 
Valencia, 43. 
Vals, 240, 242. 
Venice, 164. 
Vernet, le, 136. 
Vevay, 309. 
Vic sur Cere, 243. 
Vicars Bridge, 285. 
Vichy, 240. 
Visos, 206. 

Warmbrunn, 104, 114. 
Warrenpoint, 165. 
Wassenach, 273, 284. 
Weilbach, 202, 211. 
Weissbad, 323. 
Weissenburg, 192. 
Wiesbaden, 146, 218, 223. 
Wildbad, 104, 112. 
Wildegg, 288. 
Wildungen, 191, 273. 
Woodliill Spa, 288. 
Wyh, 272, 279. 


lonoon: s. clay, sons, and taylo: 


4 « S 



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